INTRODUCTION: The aim of this study was to evaluate ex vivo perfusion (EVP) for vascularized composite tissue preservation. We hypothesized that EVP could maintain allografts in near-physiologic conditions for ≥ 24 h. METHODS: Twenty superior epigastric artery perforator-based abdominal flaps were procured from 10 Yorkshire pigs. Flaps were preserved for 12 h (n = 5) or 24 h (n = 5) using EVP with an oxygenated colloid solution containing HBOC-201 oxygen carrier (HbO RESULTS: Ischemia time was 16 ± 6 min. There were no significant differences between the 12 h EVP and 24 h EVP groups at perfusion end for the following parameters: MAP (p = 0.63), pH (p = 0.77), pO2 (p = 0.20), venous pCO CONCLUSION: EVP preserved flaps for 24 h within physiologic parameters and without development of edema. EVP may extend preservation time for VCAs.