Experimental basis and first application of clinical lymph vessel transplantation of secondary lymphedema

Abstract

Lymphedemas due to a blockage of the lymph vessels in the root of the extremities were treated experimentally and clinically by autotransplantation of lymph vessels under the operating microscope. In experimental lymphedema of the hind leg of 10 dogs, an increased circumference of about 50% was reduced to 10% within 7 weeks by lymph vessel transplantation. After removal of the transplants, the circumferences returned to pre-transplantation values. The pre-transplantation elevated intralymphatic pressure of 12.5 torr (controls: 2.5 torr) was reduced to the normal range of 3.5 torr after the transplantation. In 8 of 10 dogs, the patency of the transplants could be demonstrated by inspection, lymphography, and isotope injections. In all 10 dogs, patency could be proved by histologic examination. The data indicate that lymph vessel transplantation can restore the diminished lymph-transporting capacity brought on by lymphedema. In 2 patients, it was possible to prepare lymph collectors about 25 cm long. After the transplantation, the circumferences diminished. By isotopes improved lymphatic transport could be demonstrated after the operation. Autologous transplantation of lymph vessels is a promising method for the treatment of secondary lymphedema especially in the early stages. © 1981 Société Internationale de Chirurgie.