A New Vascularized Cervical Lymph Node Transplantation Model

Uygur, Şafak; Öztürk, Can; Bozkurt, Mehmet; Kwiecień, Grzegorz; Madajka, Maria; Siemionow, Maria

doi:10.1097/01.sap.0000438013.15453.8c

Cited by 10 publications

(7 citation statements)

References 14 publications

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“…Since 2006 when Becker et al () reported long‐term outcomes in the first clinical series of patients who underwent vascularized lymph node transfer into the axilla ( n = 24), the technique has become more widely used for the surgical treatment of lymphedema. Maintaining the vascular supply to the transferred lymph nodes is important for survival and preservation of function (Shesol et al, ; Uygur et al, ). However, experimental studies comparing vascularized and nonvascularized lymph node transfer are still lacking in the literature (Cornelissen et al, ; Tobbia, Semple, Baker, Dumont, & Johnston, ).…”

Section: Discussionmentioning

confidence: 99%

“…In most cases, however, lymph nodes were transferred as nonvascularized free grafts with (Shioya et al, ; Tammela et al, ) or without (Aschen et al, ) fragmentation. Only a few rat models of vascularized lymph node transfer have allowed for histologic evaluation of lymph nodes transferred from the inguinal (Shesol et al, ), cervical (Uygur et al, ), and axillary regions (Kwiecien et al, ). Rats are usually used in experimental models of vascularized lymph node transfer for several reasons, including the existence of accessible lymph node basins, the moderate size of the blood vessels, which allows microsurgical vascular anastomosis, and the relative homogeneity of rodent strains.…”

Section: Discussionmentioning

confidence: 99%

“…Despite its growing popularity in lymphedema treatment (Becker et al, ; Cheng et al, ; Gharb et al, ; Ozturk et al, ; Saaristo et al, ), experimental evidence of the need for vascularization of transferred lymph nodes is lacking. The few small animal models of vascularized lymph node transfer that allow histological evaluation of the transferred lymph node are presently limited to rats (Kwiecien et al, ; Rabson, Geyer, Levine, Swartz, & Futrell, ; Shesol, Nakashima, Alavi, & Hamilton, ; Uygur et al, ).…”

Section: Introductionmentioning

confidence: 99%

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Feasibility of pedicled vascularized inguinal lymph node transfer in a mouse model: A preliminary study

et al. 2018

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Purpose: Vascularized lymph node transfer is becoming more common in the treatment of lymphedema, but suitable small animal models for research are lacking. Here, we evaluated the feasibility of pedicled vascularized inguinal lymph node transfer in mice.Methods: Twenty-five mice were used in the study. An inguinal lymph node-bearing flap with a vascular pedicle containing the superficial caudal epigastric vessels was transferred into the ipsilateral popliteal fossa after excision of the popliteal lymph node. Indocyanine green (ICG) angiography was used to confirm vascularity of the flap. ICG lymphography was performed to evaluate lymphatic flow at 3 and 4 weeks postoperatively. Patent blue dye was injected into the ipsilateral hind paw to observe staining of the transferred lymph node at 4 weeks postoperatively. All transferred lymph nodes were then harvested and histologically evaluated by hematoxylin and eosin staining.Results: In 16 of the 25 mice, ICG lymphography showed reconnection between the transferred lymph node and the afferent lymphatic vessels, as confirmed by patent blue staining. Histologically, these transferred lymph nodes with afferent lymphatic reconnection significantly regressed in size (0.37 AE 0.24 mm 2 ) and showed clear follicle formation, whereas those without afferent lymphatic reconnection showed less size regression (1.31 AE 1.17 mm 2 ); the cell population was too dense to allow identification of follicles. Conclusions:We established a mouse model of vascularized lymph node transfer with predictable afferent lymphatic reconnection. Both the vascularization and reconnection might be necessary for functional regeneration of the transferred lymph node.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Feasibility of pedicled vascularized inguinal lymph node transfer in a mouse model: A preliminary study

et al. 2018

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“…We previously described a vascularized cervical lymph node flap model in cadaver rats . The common carotid artery and the jugular vein were used as the vascular pedicles of the lymph node flap.…”

Section: Discussionmentioning

confidence: 99%

“…We previously described a vascularized cervical lymph node flap model in cadaver rats. 24 The common carotid artery and the jugular vein were used as the vascular pedicles of the lymph node flap. We identified five to six lymph nodes in the flap and used methylene blue and ICG angiography to confirm its adequate perfusion.…”

Section: Discussionmentioning

confidence: 99%

Vascularized axillary lymph node transfer: A novel model in the rat

et al. 2015

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Vascularized lymph node transfer (VLNT) is a promising microvascular free flap technique for the surgical treatment of lymphedema. To date, few experimental animal models for VLNT have been described and the viability of lymph nodes after the transfer tested. We aimed to evaluate the feasibility of axillary VLNT in the rat. Lymph node containing flaps were harvested from the axillary region in 10 Lewis rats based on the axillary vessels. Flaps were transferred to the ipsilateral groin and end-to-side microanastomosis was performed to the femoral vessels using 10-0 sutures. Indocyanine green (ICG) angiography was used to confirm flap perfusion. On postoperative day 7, flaps were elevated to assess their structure and vessel patency. Hematoxylin and eosin staining was used to confirm the presence and survival of lymph nodes. All animals tolerated the procedure well. Immediate post-procedure ICG angiography confirmed flap perfusion. No signs of ischemia or necrosis were observed in donor extremities. At postoperative day 7, all flaps remained viable with patent vascular pedicles. Gross examination and histology confirmed the presence of 3.6 ± 0.5 lymph nodes in each flap without any signs of necrosis. This study showed that the transfer of axillary lymph nodes based on the axillary vessels is feasible. The flap can be used without the need for donor animals and it contains a consistent number of lymph nodes. This reliable VLNT can be further utilized in studies involving lymphedema, transplantation, and induction of immunologic tolerance.

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Vascularized Composite Allotransplantation Models

Zor

Siemionow

2014

Plastic and Reconstructive Surgery

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A New Vascularized Cervical Lymph Node Transplantation Model

Cited by 10 publications

References 14 publications

Feasibility of pedicled vascularized inguinal lymph node transfer in a mouse model: A preliminary study

Feasibility of pedicled vascularized inguinal lymph node transfer in a mouse model: A preliminary study

Vascularized axillary lymph node transfer: A novel model in the rat

Vascularized Composite Allotransplantation Models

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