title: Complications of autologous lymph-node transplantation for limb lymphoedema.
abstract: OBJECTIVE
  This study aims to assess potential complications of autologous lymph-node transplantation (ALNT) to treat limb lymphoedema.
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  All limb-lymphoedema patients, followed up in a single lymphology department, who decided to undergo ALNT (January 2004-June 2012) independently of our medical team, were included.
  
  
  RESULTS
  Among the 26 patients (22 females, four males) included, 14 had secondary upper-limb lymphoedema after breast-cancer treatment and seven had secondary and five primary lower-limb lymphoedema. Median (interquartile range, IQR) ages at primary lower-limb lymphoedema and secondary lymphoedema onset were 18.5 (13-30) and 47.4 (35-58) years, respectively. Median body mass index (BMI) was 25.9 (22.9-29.3) kg m⁻². For all patients, median pre-surgery lymphoedema duration was 37 (24-90) months. Thirty-four ALNs were transplanted into the 26 patients, combined with liposuction in four lower-limb-lymphoedema patients. Ten (38%) patients developed 15 complications: six, chronic lymphoedema (four upper limb, two lower limb), defined as ≥2-cm difference versus the contralateral side, in the limb on the donor lymph-node-site territory, persisting for a median of 40 months post-ALNT; four, post-surgical lymphocoeles; one testicular hydrocoele requiring surgery; and four with persistent donor-site pain. Median (IQR) pre- and post-surgical lymphoedema volumes, calculated using the formula for a truncated cone, were, respectively, 1023 (633-1375) ml (median: 3 (1-6) months) and 1058 (666-1506) ml (median: 40 (14-72) months; P = 0.73).
  
  
  CONCLUSIONS
  ALNT may engender severe, chronic complications, particularly persistent iatrogenic lymphoedema. Further investigations are required to evaluate and clearly determine its indications.
authors.affiliation: Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq-Jay, 15, rue Eugène Millon, 75015 Paris, France. stephane.vignes@cognacq-jay.fr
authors.forename: S
authors.initials: S
authors.lastname: Vignes
authors.forename: M
authors.initials: M
authors.lastname: Blanchard
authors.forename: A
authors.initials: A
authors.lastname: Yannoutsos
authors.forename: M
authors.initials: M
authors.lastname: Arrault
mesh_terms: D000293:Adolescent; D000328:Adult; D005121:Extremities; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000637:transplantation*; D008209:Lymphedema / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D014182:Transplantation, Autologous / Q000009:adverse effects; D055815:Young Adult