title: Donor-site lymphatic function after microvascular lymph node transfer.
abstract: BACKGROUND
  Lymphedema remains a challenging clinical problem that often lacks curative treatment options. Recent reports have shown that microvascular lymph node transfer from the groin area into axillas of lymphedematous patients may improve lymphatic drainage, but the effect on donor-site lymphatic flow has not been studied. These patients may be more prone to develop lymphedema at donor sites as well; therefore, the authors' aim was to evaluate postoperative donor-site lymphatic function.
  
  
  METHODS
  The authors performed lymphatic groin flap transfer to the axilla in 13 lymphedema patients. In 10 patients, the lymph node transfer was performed simultaneously with lower abdominal breast reconstruction. Postoperative lymphatic vessel function of the donor site was evaluated by lymphoscintigraphy and limb circumference measurements. For semiquantitative evaluation of lymphatic drainage, a numerical transport index was used.
  
  
  RESULTS
  In six of 10 patients, postoperative lymphoscintigraphy revealed minor changes in lymphatic flow of the donor-site limbs. The transport index was considered slightly abnormal in two of 10 patients. None of the 13 patients had changes in lower limb circumferences during the 8- to 56-month follow-up.
  
  
  CONCLUSIONS
  Lymph node transfer can be easily combined with lower abdominal breast reconstruction, and the popularity of this technique is increasing rapidly. Even though none of our patients had developed symptoms of postoperative lymphedema, the results of the first lymphoscintigrams show that it is important to reduce the surgical trauma to the lymphatic flap donor site.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Turku, Finland From Plastic Surgery and the Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, and Turku PET Center.
authors.forename: Tiina P
authors.initials: TP
authors.lastname: Viitanen
authors.forename: Maija T
authors.initials: MT
authors.lastname: Mäki
authors.forename: Marko P
authors.initials: MP
authors.lastname: Seppänen
authors.forename: Erkki A
authors.initials: EA
authors.lastname: Suominen
authors.forename: Anne M
authors.initials: AM
authors.lastname: Saaristo
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps; D006119:Groin; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation*; D042601:Lymphatic Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology; D008209:Lymphedema / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D061305:Lymphoscintigraphy; D016462:Mammaplasty; D008408:Mastectomy; D008866:Microsurgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D060053:Transplant Donor Site / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016896:Treatment Outcome