title: Lymphedema after upper limb transplantation: scintigraphic study in 3 patients.
abstract: Lymphatic vasculature is known to spontaneously reconnect after hand replantation. Nonetheless, lymphatic outflow has not been specifically studied in hand transplantation.Lymphedema was studied clinically and scintigraphically in 3 bilateral upper limb transplants performed in Valencia, Spain, since 2006. Case 1 was a radiocarpal level, case 2 midforearm and proximal forearm, and case 3 was a transhumeral transplantation. Follow-up was 5, 4, and 3 years, respectively. Clinically, in case 1, there was a left-sided moderate lymphedema, case 2 was normal, and a right-sided moderate lymphedema was present in case 3. Lymphoscintigraphy results were consistent with the clinical findings. It was normal in the 4 nonedematous limbs. In the 2 affected limbs, there were scintigraphic findings of lymphatic block and lymphangiectasia.The study demonstrates objectively that lymphatic circulation can reconnect spontaneously in hand transplantations, although not in a homogeneously efficient way.
authors.affiliation: Reconstructive Surgery, Clínica Cavadas, Hospital de Manises, Valencia, Spain. pcavadas@telefonica.net
authors.forename: Pedro C
authors.initials: PC
authors.lastname: Cavadas
authors.forename: Alessandro
authors.initials: A
authors.lastname: Thione
authors.forename: Alexo
authors.initials: A
authors.lastname: Carballeira
authors.forename: Pablo Caro
authors.initials: PC
authors.lastname: Dominguez
mesh_terms: D000673:Amputation, Traumatic / Q000601:surgery; D005542:Forearm / Q000601:surgery; D005543:Forearm Injuries / Q000601:surgery*; D063987:Hand Transplantation; D006801:Humans; D008200:Lymphangiectasis / Q000000981:diagnostic imaging; D042601:Lymphatic Vessels / Q000503:physiopathology*; D008209:Lymphedema / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid; D034941:Upper Extremity / Q000601:surgery*; D063986:Vascularized Composite Allotransplantation
chemical_list: D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid