Lymph node transplantation results in spontaneous lymphatic reconnection and restoration of lymphatic flow.
BACKGROUND
Although lymph node transplantation has been shown to improve lymphatic function, the mechanisms regulating lymphatic vessel reconnection and functional status of lymph nodes remains poorly understood.


METHODS
The authors developed and used LacZ lymphatic reporter mice to examine the lineage of lymphatic vessels infiltrating transferred lymph nodes. In addition, the authors analyzed lymphatic function, expression of vascular endothelial growth factor (VEGF)-C, maintenance of T- and B-cell zone, and anatomical localization of lymphatics and high endothelial venules.


RESULTS
Reporter mice were specific and highly sensitive in identifying lymphatic vessels. Lymph node transfer was associated with rapid return of lymphatic function and clearance of technetium-99 secondary to a massive infiltration of recipient mouse lymphatics and putative connections to donor lymphatics. T- and B-cell populations in the lymph node were maintained. These changes correlated with marked increases in the expression of VEGF-C in the perinodal fat and infiltrating lymphatics. Newly formed lymphatic channels in transferred lymph nodes were in close anatomical proximity to high endothelial venules.


CONCLUSIONS
Transferred lymph nodes have rapid infiltration of functional host lymphatic vessels and maintain T- and B-cell populations. This process correlates with increased endogenous expression of VEGF-C in the perinodal fat and infiltrating lymphatics. Anatomical proximity of newly formed lymphatics and high endothelial venules supports the hypothesis that lymph node transfer can improve lymphedema by exchanges with the systemic circulation.
New York, N.Y.; and Madrid, Spain From the Division of Plastic and Reconstructive Surgery, Memorial Sloan-Kettering Cancer Center; and the Biotechnology Programme, Spanish National Cancer Research Centre.
Seth Z
SZ
Aschen
Gina
G
Farias-Eisner
Daniel A
DA
Cuzzone
Nicholas J
NJ
Albano
Swapna
S
Ghanta
Evan S
ES
Weitman
Sagrario
S
Ortega
Babak J
BJ
Mehrara
D000818:Animals; D008198:Lymph Nodes / Q000502:physiology* / Q000637:transplantation*; D042601:Lymphatic Vessels / Q000502:physiology* / Q000601:surgery*; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL