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Vascularized Lymph Node Transplant (VLNT): Four Year Prospective Outcomes
Stav Brown
*, Michelle Coriddi, Babak Mehrara, Joseph Dayan
Plastic and Reconstructive Surgery , Memorial Sloan Kettering Cancer Center, New York , NY
BACKGROUND: While safety and efficacy of vascularized lymph node transplant (VLNT) has been established up to 2 years postoperatively, there is a paucity of published data beyond this point. The purpose of this prospective study was to evaluate outcomes four years post-operatively using all available metrics.
METHODS: All patients underwent VLNT at a tertiary cancer center between November 2014 and July 2023. Outcomes were assessed with 2 validated patient-reported outcome metrics (PROMs), limb volume, bioimpedance, need for compression, and incidence of cellulitis.
RESULTS: A total of 117 patients were included with the following donor sites: omentum (79.5%), axilla (10%), supraclavicular (5%) and groin (2.5%). The mean follow-up time was 43.8±11 months. There was a significant improvement at 4 years postoperatively across all outcome measures: 27.5% average reduction in limb volume (p=0.04), 30.8% improvement (p=0.01) in bioimpedance (LDEX) scores, 21.2% improvement in the Lymphedema Life Impact Scale scores (p=0.03) and 97% reduction in cellulitis (p=0.001). 43% of patients no longer required compression. No cases of donor site lymphedema were recorded (0%).
CONCLUSION: VLNT yields durable improvement in overall limb volume and quality of life beyond two years with continued improvements through the four-year post-op mark.
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