Isolated limb perfusion (ILP) and isolated limb infusion (ILI)

Chemotherapy can be given directly into a limb to help control melanoma that has come back in one area. It can only be given if the melanoma has not spread elsewhere in the body.

There are two ways of giving chemotherapy into a limb:

  • isolated limb perfusion (ILP)
  • isolated limb infusion (ILI).

These treatments are only carried out in some specialist UK centres.

Isolated limb perfusion is given under general anaesthetic, and you will stay in hospital for 3 to 7 days. The procedure is done by a surgeon who specialises in operations involving blood vessels (a vascular surgeon).

Your surgeon will disconnect the blood flow from your limb to the rest of your body. Anti-cancer drugs are then pumped through the limb, before the surgeon reconnects the blood supply to the rest of the body.

Isolated limb infusion is a simpler procedure, but the blood from the limb does not go through a pump.

After your procedure, a nurse will closely monitor your limb and make sure your blood flow is normal.

Chemotherapy into an arm or leg

You may be given chemotherapy directly into an arm or leg (limb) to treat clusters of melanomas that have come back in the same limb. These clusters of melanomas are called satellite lesions or in-transit lesions. This treatment is only given if the melanoma has not spread anywhere else in the body.

There are two ways of giving chemotherapy into a limb:

  • isolated limb perfusion (ILP)
  • isolated limb infusion (ILI).

Some targeted therapies can also be given in the same way.

These treatments are only carried out in some specialist centres in the UK. Your doctor or specialist nurse will give you more information about the drugs you will have.


Isolated limb perfusion (ILP)

This involves giving high doses of chemotherapy or targeted therapy drugs directly into the affected limb. The blood supply to the limb is isolated from the rest of the body so that the drugs do not go to other areas of your body. You are therefore unlikely to get the side effects the drugs usually cause when they circulate around the body.

You will be given a general anaesthetic. The surgeon temporarily disconnects the blood flow between your affected limb and the rest of your body. The limb is then isolated using a tight band (tourniquet). Blood from the limb is circulated through an external pump where the drugs can be added, before going back into your limb. Oxygen will also be added to your blood as it circulates through the pump. This is because your limb still needs to get oxygen during the treatment. Your blood will be heated, as some research shows that this improves the results of the treatment.

After the procedure, the blood flow from your limb is reconnected to the rest of your body and the tourniquet is removed. The blood supply to your limb goes back to normal.

Your hospital team will tell you how long the treatment will take. You will usually have to stay in hospital for 3 to 7 days after the procedure.

The main side effects of this treatment are swelling, redness and occasionally blistering of the skin on the affected limb.


Isolated limb infusion (ILI)

This is similar to isolated limb perfusion and may be used as an alternative. Unlike ILP, the blood doesn’t circulate through a pump and no oxygen is added. This makes the treatment shorter. The chemotherapy or targeted therapy drugs will be added in a similar way and will circulate in your limb for about 20 to 25 minutes.

Your doctors will be able to tell you more about isolated limb infusion if this is a suitable treatment for you.

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