ArticlePlastic and reconstructive surgery. Global open2026
A Practical Algorithm for Donor- and Recipient-site Selection in Vascularized Lymph Node Transfer in Extremity Lymphedema.
Article in Plastic and reconstructive surgery. Global open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Artificial Intelligence and Robotic Surgery in Lymphedema: A Scoping Review of Current Applications, Clinical Translation, and Evidence Gaps.Plastic and reconstructive surgery. Global open · 2026Article
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Vascularized lymph node transfer (VLNT) involves the autologous transplantation of functioning lymph nodes to a lymphedematous region. Despite various donor and recipient sites, comparative effectiveness and complication rates remain understudied. This study aims to develop an evidence-based algorithm for donor- and recipient-site selection in VLNT. Methods: A prospectively maintained database was reviewed for patients who underwent unilateral VLNT for chronic extremity lymphedema between January 1, 2016, and December 31, 2023. Surgical effectiveness was assessed using circumferential limb measurements over time. Complications were graded according to the Clavien-Dindo classification. Results: Among 161 patients, donor sites included groin (n = 129, 80.1%), lateral thoracic (n = 16, 9.9%), mesenteric (n = 13, 8.1%), and omental (n = 3, 1.9%) flaps, all of which demonstrated comparable long-term effectiveness. For upper extremity lymphedema, axillary placement (n = 125, 94.7%) resulted in faster and greater volume reductions than distal forearm placement (n = 6, 4.5%). For lower extremity lymphedema, lower leg placement (n = 18, 62.1%) was more effective than the groin (n = 10, 31.0%). Waterjet-assisted liposuction provided transient improvements only, without long-term benefits. Complications occurred in 14 (8.7%) patients and were exclusively observed after groin-based (n = 12, 9.1%) or thoracic-based VLNTs (n = 2, 6.9%). Conclusions: Donor-site selection should prioritize minimizing morbidity, given their comparable long-term effectiveness. In contrast, recipient-site selection significantly impacts outcomes, with axillary and lower leg placements demonstrating greater effectiveness. Scar tissue release may have a more influential role in VLNT outcomes than previously recognized.
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Registered trials
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