Lymph Node Transfer

Vascularized lymph node transfers (VLNT) can be extremely effective for the treatment of lymphedema of the arm or leg. The technique can either replace lymph nodes lost through surgery and/or radiation with healthy, functioning lymph nodes and tissues taken from elsewhere in the body or add lymph nodes to further improve lymphatic drainage.

Lymph nodes are harvested with their supporting artery and vein for blood supply. Using specialized microsurgical techniques, Dr. Granzow then reconnects the artery and vein to recipient blood vessels in the axilla to provide vital support to the lymph nodes during the initial healing phase.

The newly transferred lymph nodes heal, improve lymphatic drainage and can bridge damaged tissue. They then serve as a new and permanent conduit or filter to remove the excess lymphatic fluid from the arm and return it to the body’s natural circulation.

Vascularized Lymph Node Transfers (VLNT) Surgery Diagram
Vascularized Lymph Node Transfers (VLNT) Surgery Diagram
Lymph nodes can also be moved independently from the groin to the axilla (armpit) to improve lymphedema symptoms in the arm, breast and torso.
Vascularized Lymph Node Transfers (VLNT) Surgery Diagram
Vascularized Lymph Node Transfers (VLNT) Surgery Diagram
Lymph nodes can also be moved independently from the side of the torso to the groin area or leg to improve drainage in the leg.
Vascularized Lymph Node Transfers (VLNT) Surgery Diagram
Vascularized Lymph Node Transfers (VLNT) Surgery Diagram
VLNT also can be performed in conjunction with a DIEP flap breast reconstruction. This allows for treatment of the arm lymphedema and the simultaneous creation of a natural appearing and soft breast in one surgery. Abdominal contouring, similar to a tummy tuck, is also achieved.

For this technique to be successful, the swelling in the extremity must be composed of mostly lymphatic fluid. Individuals with deposition of solid in the form of fat or protein require Suction-Assisted Protein Lipectomy (SAPL) to reduce the size of the limb.

In Taiwan, Dr. Ming-Huei Cheng performs lymph nodes transfers to the wrist and has shown significant improvements in both symptoms and lymphoscintigraphy scans after surgery.



Dr. Granzow with Dr. Ming-Huei Cheng in Taiwan in 2005
We have seen significant improvements in many patients’ lymphedema symptoms with this technique. We have had many patients be able to completely eliminate the need for routine compression garment use following our VLNT surgery.