Lymphedema is mainly characterized by swelling, fibrosis, and nonpitting edema. The aim of this study was evaluation of the long-term (10 years) effects of autologus lymphatic tissue implant in lymphedema. Lymphatic tissue from 9 patients (harvested form the same patient in areas not affected by lymphedema) was reimplanted into the affected limb, and these patients were followed for 10 years. Lymph nodes were harvested at the neck, axillary, or inguinal space (contralateral limb). Results showed that limb volume was decreased in the treatment group vs. controls. In ultrasound, black, low density, lymphatic spaces were visible in 100% of patients at inclusion but in only 23% of these subjects at 10 years. Thus, this early report proposes a new, minimally invasive method to improve lymphedema. Studies in progress will indicate the role of lymphatic transplant in the management of lymphedema and the best indications for this method.
Belcaro G., Nicolaides AN, Veller M.Venous Disorders. A Manual of Diagnosis and Treatment. London: Saunders; 1998.
2.
Belcaro G., Nicolaides AN, Stansby G.The Venous Clinic. London: Imperial College Press; 2000.
3.
Belcaro G., Nicolaides ANNoninvasive Investigations in Vascular Diseases. London : Imperial College Press; 2003.
4.
Goldstone J.Veins and lymphatics. In: Way LW, ed. Current Surgical Diagnosis & Treatment. Stamford: Appleton & Lange; 1994:783-809.
5.
Cesarone MR, Belcaro G., Nicolaides AN, Arkans E., Laurora G.The edema tester in the evaluation of swollen limbs in venous and lymphatic disease. Panminerva Med. 1999;41:10-14.
6.
Cesarone MR, Laurora G., Steigerwalt R., Belcaro G.Edema tester. Assessment of edema of the legs. Minerva Med . 1998;89:309-313.
7.
Reichl D., Myant NB, Pflug JJConcentration of lipoproteins containing apolipoprotein B in human peripheral lymph. Biochim Biophys Acta. 1977 ;489:98-105.
8.
Reichl D., Myant NB, Pflug JJ, Rudra DNThe passage of apoproteins from plasma lipoproteins into the lipoproteins of peripheral lymph in man. Clin Sci Mol Med. 1977;53:221-226.
9.
Reichl D., Postiglione A., Myant NB, Pflug JJ, Press M.Observations on the passage of apoproteins from plasma lipoproteins into peripheral lymph in two men. Clin Sci Mol Med. 1975;49:419-426.
10.
Reichl D., Simons LA, Myant NB, Pflug JJ, Mills GLThe lipids and lipoproteins of human peripheral lymph, with observations on the transport of cholesterol from plasma and tissues into lymph. Clin Sci Mol Med. 1973;45:313-329.
11.
Cesarone MR , De Sanctis MT, Laurora G., Belcaro G. Lymphedema.New non-invasive methods for diagnosis and follow up. Minerva Cardioangiol . 1995;43:211-218.
12.
McColl BK, Stacker SA, Achen MGMolecular regulation of the VEGF family—inducers of angiogenesis and lymphangiogenesis. Vasc Endovascular Surg . 2005;39: 67-81.
13.
Vignes S., Boursier V., Trevidic P.Interest of cutaneous resection after reduction of volume by decongestive physiotherapy in huge primary lymphedema of lower limb. J Mal Vasc. 2005;30:181-185.
14.
O'Brien JG, Chennubhotla SATreatment of edema. Am Fam Physician. 2005 ;71:2111-2117.
15.
Bernas M., Witte M., Kriederman B., Summers P., Witte C.Massage therapy in the treatment of lymphedema. Rationale, results, applications . IEEE Eng Med Biol Mag. 2005 ;24:58-68.
16.
Spry CJ, Pflug AJ, Janossy G., Humphrey JHLarge mononuclear (veiled) cells like `Ia-like' membrane antigens in human afferent lymph. Clin Exp Immunol. 1980;39:750-755.
17.
McColl BK, Stacker SA, Achen MGMolecular regulation of the VEGF family—inducers of angiogenesis and lymphangiogenesis. APMIS. 2004;112:463-480.
18.
Lee BB, Kim YW, Seo JM, Hwang JH, Do YS, Kim DI, et al. Current concepts in lymphatic malformation. Vasc Endovascular Surg.2005;39:67-81.
19.
An A., Rockson SGThe potential for molecular treatment strategies in lymphatic disease . Lymphat Res Biol. 2004;2:173-181.
20.
Falagas ME, Vergidis PINarrative review: diseases that masquerade as infectious cellulitis . Ann Intern Med. 2005;142(1):47-55.
21.
Temple C., Strom E., Youssef A., Langstein H.Choice of recipient vessels in delayed TRAM flap breast reconstruction after radiotherapy. Plast Reconstr Surg. 2005 ;115:105-113.
22.
Enjolras O. , Chapot R., Merland JJVascular anomalies and the growth of limbs: a review. J Pediatr Orthop B. 2004;13:349-357.
23.
Pardini M., Bonzano L., Roccatagliata L., Boccardo F., Mancardi G., Campisi C.Functional magnetic resonance evidence of cortical alterations in a case of reversible congenital lymphedema of the lower limb: a pilot study . Lymphology. 2007;40:19-25.
24.
Campisi C., Eretta C., Pertile D., Da Rin E., Campisi C., Maccio A., Campisi M., Accogli S., Bellini C., Bonioli E., Boccardo F.Microsurgery for treatment of peripheral lymphedema: long-term outcome and future perspectives. Microsurgery. 2007 ;27:333-338.
25.
Campisi C., Davini D., Bellini C., Taddei G., Villa G., Fulcheri E., et al. Lymphatic microsurgery for the treatment of lymphedema. Microsurgery. 2006;26:65-69.
26.
Cao WG, Li SL, Zhou JG, Cheng KX, Liu NF, Zhang DSTreatment of primary lower limb lymphedema with ultrasonic assisted liposuction . Zhonghua Zheng Xing Wai Ke Za Zhi. 2006;22:290-291.
27.
Gomatos IP, Filippakis G., Albanopoulos K., Zografos G., Leandros E., Bramis J., et al. Complete endoscopic axillary lymph node dissection without liposuction for breast cancer: initial experience and mid-term outcome. Surg Laparosc Endosc Percutan Tech. 2006;16:232-235.
28.
Brorson H., Ohlin K., Olsson G., Langstrom G., Wiklund I., Svensson H.Quality of life following liposuction and conservative treatment of arm lymphedema . Lymphology. 2006; 39:8-25.
29.
Kriederman BM, Myloyde TL, Witte MH, Dagenais SL, Witte CL, Rennels M., et al. FOXC2 haploinsufficient mice are a model for human autosomal dominant lymphedema-distichiasis syndrome. Hum Mol Genet. 2003; 12(10):1179-1185.
30.
Witte MH, Bernas MJ, Martin CP, Witte CLLymphangiogenesis and lymphangiodysplasia: from molecular to clinical lymphology . Microsc Res Tech. 2001;55:122-145.
31.
Bernas MJ, Witte CL, Witte MH; International Society of Lymphology Executive Committee. The diagnosis and treatment of peripheral lymphedema: draft revision. Lymphology . 2001;34:84-91.
32.
Holberg CJ, Erickson RP, Bernas MJ, Witte MH, Fultz KE, Andrade M., Witte CLSegregation analyses and a genome-wide linkage search confirm genetic heterogeneity and suggest oligogenic inheritance in some Milroy congenital primary lymphedema families. Am J Med Genet. 2001;98:303-312.
33.
Witte CL, Witte MH, Unger EC, Williams WH, Bernas MJ, McNeill GC, et al. Advances in imaging of lymph flow disorders. Radiographics. 2000;20:1697-1719.
34.
Boursier V. , Pecking A., Vignes S.Comparative analysis of lymphoscintigraphy between lipedema and lower limb lymphedemaJ Mal Vasc. 2004;29:257-261.
35.
Schoder H., Glass EC, Pecking AP, Harness JK, Wallace AM, Hirnle P. et al. Larson SM. Molecular targeting of the lymphovascular system for imaging and therapy. Cancer Metastasis Rev.2006;25:185-201.
36.
Lohrmann C. , Foldi E., Bartholoma JP, Langer M.MR imaging of the lymphatic system: distribution and contrast enhancement of gadodiamide after intradermal injection. Lymphology. 2006;39:156-163.
37.
Augustin M. , Bross F., Foldi E., Vanscheidt W., Zschocke I.Development, validation and clinical use of the FLQA-I, a disease-specific quality of life questionnaire for patients with lymphedema. Vasa. 2005;34:31-35.
38.
Foldi M.Remarks concerning the consensus document (CD) of the International Society of Lymphology: “The diagnosis and treatment of peripheral lymphedema .” Lymphology. 2004;37:168-173.
39.
Foldi M.The neglected vascular system—4,5 million Germans suffer from lymphedema. MMWFortschr Med.2004;146:23-24.
40.
Linnitt N.Lymphoedema: recognition, assessment and management. Br J Community Nurs. 2005;10: S20-S26.
