Isolated Limb Perfusion

A close-up of three surgeons in the operating room

Isolated limb perfusion (ILP) is a regional therapy for melanoma.

It is used to treat advanced melanomas in your arm or leg. ILP may be appropriate for you if excision is not feasible without significant tissue damage or if it seems unlikely to keep your cancer from spreading.

What Is Isolated Limb Perfusion?

If you have melanoma in your arm or leg, isolated limb perfusion can deliver a high-dose of chemotherapy directly to your affected limb. This complex procedure allows you to receive a much more targeted and higher dose of chemotherapy than you’d be able to get intravenously.

What Should I Expect During Isolated Limb Perfusion?

During Isolated Limb Perfusion, a surgeon will isolate your limb by surgically placing canullas (thin tubes) in the arteries and veins of your affected arm or leg. This cuts off blood circulation to your limb.

The procedure requires a perfusion team and a perfusion circuit to deliver very high doses of a chemotherapy drug directly to the affected arm or leg for an hour. By isolating your arm or leg from your circulatory system, we can administer chemotherapy under mildly hyperthermic (heated) conditions without the associated side effects to the rest of your body. After the treatment period, chemotherapy is flushed from your arm or leg and circulation is re-established.

At Penn Medicine, the heart and vascular team assists the oncologic surgery team during ILP since it is a complex vascular procedure.

Who Is a Candidate for Isolated Limb Perfusion?

You might be a candidate for ILP if you have in-transit melanoma or melanoma that has multiple subcutaneous (under the skin) tumor nodules throughout your arm or leg and away from the primary melanoma site

Aside from ILP, we have several options — both surgical and medical — to treat in-transit melanoma. These include immunotherapy or targeted therapy, as well as local injectable therapies.