Risk of donor-site lymphatic vessel dysfunction after microvascular lymph node transfer

Area of Science:

• Regenerative Medicine
• Vascular Surgery
• Lymphatic Research

Background:

• Microvascular lymph node transfer is a treatment for lymphoedema.
• Previous studies indicated lymphatic function changes in the donor limb post-transfer.
• A modified, more conservative surgical approach was developed to mitigate these changes.

Purpose of the Study:

• To evaluate the impact of a modified, conservative microvascular lymph node transfer technique on donor limb lymphatic function.
• To compare the outcomes of the modified technique with the original method.

Main Methods:

• 13 patients underwent the original lymph node transfer method.
• 16 patients underwent the modified, conservative lymph node transfer method.
• Lymphatic function in the donor limb was assessed using volumetry, lymphoscintigraphy, and tissue water percentage.

Main Results:

• The modified method resulted in a smaller volume difference between donor and control limbs compared to the original method.
• Lymphoscintigraphy revealed normal lymphatic transport in the modified group, unlike two patients in the original group.
• No patients in either group developed clinical lymphoedema in the donor limb during follow-up (11-84 months).

Conclusions:

• Even conservative lymph node transfer can lead to subtle, subclinical lymphatic dysfunction in the donor limb.
• Minimizing surgical dissection in the inguinal area is vital.
• Avoiding damage to lymphatic vessels and sentinel nodes of the lower limb is essential to preserve donor limb lymphatic function.