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Raman et al. Plast Aesthet Res 2023;10:6 Plastic and
DOI: 10.20517/2347-9264.2022.62
Aesthetic Research

Systematic Review Open Access

Vascularized lymph node transfer for the treatment
of lymphedema: a systematic review and meta-

analysis of clinical and patient-reported outcomes

2,#
1,#
2
3
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Shreya Raman , Sai Anusha Sanka , Jenny Ji , Lauren Yaeger , Gary B. Skolnick , Joani M.
Christensen 2
1
Division of Plastic and Reconstructive Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA.
2
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
3
Bernard Becker Medical Library, Washington University School of Medicine, St. Louis, MO 63110, USA.
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Authors contributed equally to this publication.
Correspondence to: Dr. Joani M. Christensen, Division of Plastic and Reconstructive Surgery, Washington University in St. Louis,
Northwest Tower 660 South Euclid Avenue, Suite 1150, Campus Box 8238, St. Louis, MO 63110, USA. E-mail: c.joani@wustl.edu
How to cite this article: Raman S, Sanka SA, Ji J, Yaeger L, Skolnick GB, Christensen JM. Vascularized lymph node transfer for the
treatment of lymphedema: a systematic review and meta-analysis of clinical and patient-reported outcomes. Plast Aesthet Res
2023;10:6. https://dx.doi.org/10.20517/2347-9264.2022.62
Received: 16 Jun 2022 First Decision: 15 Nov 2022 Revised: 12 Dec 2022 Accepted: 10 Feb 2023 Published: 21 Feb 2023

Academic Editors: Melissa B. Aldrich, Efterpi Demiri Copy Editor: Ying Han Production Editor: Ying Han

Abstract
Aim: The aim of this systematic review was to summarize clinical and patient-reported outcomes (PROs) for
various vascularized lymph node transfer (VLNT) donor sites and identify gaps in the literature to guide future
research.
Methods: A literature search of five databases was performed for articles related to VLNT that were published
prior to November 2021. Studies that included clinical outcomes or PROs from at least five adult patients who
received VLNTs to treat lymphedema were included.

Results: Sixty-six studies met the study criteria. Most studies reported improved limb circumference/volume,
reduction or discontinuation of conservative therapy, infection rate reduction, improved PROs, or postoperative
imaging findings reflecting functional lymph nodes. There were significantly lower infection rates (P < 0.05) and a
trend towards improved PROs in patients who received intra-abdominal flaps, but overall few studies reported
these outcomes. There were no significant differences in complication rates at the donor or recipient site based on
VLNT donor sites, or between intra-abdominal vs. extra-abdominal VLNT donor sites, although these outcomes are

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0
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