Experimental observation of transplantation of vein graft to lymphatics

We attempted to transplant a vein graft to normal lymphatics (LVL) to investigate whether it could survive and remain joined to the lymphatics as the environment changed. A total of 152 rabbits were divided into 3 groups. Group 1 was an LVL saline-irrigated group (n = 40), with a patency rate of 52.5%. Group 2 was an LVL nonirrigated group (n = 34), with a patency rate of 29.4%. Group 3 was an LV group (n = 78), with a patency rate of 32%. All specimens were examined under either light microscope or scanning electron microscope. The data indicated that an LVL anastomosis is practical and that preanastomotic irrigation can improve the patency rate. In both the LVL and the LV groups, endothelial regeneration, originating from the adjacent endothelium, commenced within 1 week after the anastomosis, with complete healing within 3 to 4 weeks. The vein graft tended to become "lymphaticized." Thrombosis was the main cause of obstruction. The patency rate can be increased by irrigation of the ends with saline before performing the anastomosis. The graft intima must be kept intact, the nutritive blood vessels of the lymphatics must be preserved, and the flow must be artificially increased soon after the anastomosis.