Systemic effects of hyperthermic isolated lower limb perfusion with carboplatin and interferon-beta

The changes in systemic circulation during hyperthermic isolated lower limb perfusion with carboplatin and interferon-p were investigated in 19 patien ts with malignant melanoma. The cardiac output (CO) increased significantly (p < 0.01) from 3.81 +/- 0.22 L/min before the procedure to 5.30 +/- 0.49 L/min 1 h after hyperthermic perfusion. The double product (mean arterial p ressure x heart rate) also increased significantly (p < 0.01) from 5,145 +/ - 372 mm Hg/min to 6,760 +/- 486 mm Hg/min. In some patients, it increased to more than twice the control value. These changes were accompanied by an increase in body temperature, presumably caused dy the systemic leakage of both warmed blood and interferon-p. Blood chemistry data demonstrated no si gnificant changes in the liver or renal function. However, the serum CPK le vel increased markedly on the first postoperative day, and persisted for 1 week, thus suggesting that some muscle damage occurred during the procedure . There was no operative death or severe complications. From these data, we concluded that hyperthermic isolated limb perfusion with interferon-p is a relatively safe therapeutic method for malignant melanoma of the extremiti es. However, care should be taken in patients with ischemic heart disease w ho may suffer a heart attack due to the rapid increase in cardiac work duri ng the procedure.