Synergistic Effect of Stromal Vascular Fraction and Lymph Node Transfer in a Rabbit Hindlimb Model

Area of Science:

• Regenerative Medicine
• Vascular Biology
• Stem Cell Therapy

Background:

• Adipose-derived stem cells (ADSCs) promote lymphangiogenesis, but their integration with vascularized lymph node transfer (VLNT) is underexplored.
• Stromal vascular fraction (SVF) offers an intraoperative alternative to ADSCs, enabling single-stage VLNT procedures.
• This study investigates the synergistic effects of combining VLNT with SVF therapy.

Purpose of the Study:

• To evaluate the impact of combined VLNT and SVF therapy on lymphedema in a rabbit hindlimb model.
• To assess the enhancement of lymph node viability and structural integrity post-treatment.
• To determine the role of SVF in promoting lymphangiogenesis within the VLNT context.

Main Methods:

• New Zealand white rabbits were assigned to control, VLNT only, SVF only, or combined VLNT plus SVF groups.
• VLNT involved transferring a pedicled lymph node flap; SVF was injected into perinodal tissue.
• Postoperative assessments included edema measurement, ICG lymphography, histology, and VEGF-C/LYVE-1 expression analysis.

Main Results:

• Combined VLNT plus SVF significantly reduced hindlimb edema by week 4 compared to controls.
• Histology revealed superior structural integrity and reduced fibroadipose tissue in the combined treatment group.
• Elevated VEGF-C and LYVE-1 expression were observed in SVF-treated and combined groups, respectively.

Conclusions:

• SVF effectively integrates with VLNT in a single-stage procedure, improving vascularized lymph node viability and structure.
• This combined approach shows potential as a therapeutic strategy for advanced lymphedema.
• Further clinical trials are warranted to explore the efficacy of combined VLNT and SVF therapy.