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Sterile Inflammation after Lymph Node Transfer Improves Lymphatic Function and Regeneration

Joseph, Walter J. B.S.; Aschen, Seth B.S.; Ghanta, Swapna M.D.; Cuzzone, Daniel M.D.; Albano, Nicholas B.S.; Gardenier, Jason M.D.; Savetsky, Ira M.D.; Torrisi, Jeremy B.A.; Mehrara, Babak J. M.D.

Plastic and Reconstructive Surgery: July 2014 - Volume 134 - Issue 1 - p 60–68
doi: 10.1097/PRS.0000000000000286
Experimental: Original Articles

Background: The aim of this study was to determine whether sterile inflammatory reactions can serve as a physiologic means of augmenting lymphangiogenesis in transplanted lymph nodes using a murine model.

Methods: The authors used their previously reported model of lymph node transfer to study the effect of sterile inflammation on lymphatic regeneration. Mice were divided into three groups: group 1 (controls) underwent lymphadenectomy followed by immediate lymph node transplantation without inflammation; group 2 (inflammation before transfer) underwent transplantation with lymph nodes harvested from donor animals in which a sterile inflammatory reaction was induced in the ipsilateral donor limb; and group 3 (inflammation after transfer) underwent transplantation with lymph nodes and then inflammation was induced in the ipsilateral limb. Lymphatic function, lymphangiogenesis, and lymph node histology were examined 28 days after transplantation and compared with those of normal lymph nodes.

Results: Animals that had sterile inflammation after transplantation (group 3) had significantly improved lymphatic function (>2-fold increase) on lympho scintigraphy, increased perinodal lymphangiogenesis, and functional lymphatics compared with the groups with no inflammation and inflammation before transplantation (p < 0.01). Inflammation after transplantation was associated with a more normal lymph node architecture, expansion of B-cell zones, and decreased percentage of T cells compared with the other experimental groups.

Conclusions: Sterile inflammation is a potent method of augmenting lymphatic function and lymphangiogenesis after lymph node transplantation and is associated with maintenance of lymph node architecture. Induction of inflammation after transplantation is the most effective method and promotes maintenance of normal lymph node B- and T-cell architecture.

New York, N.Y.

From the Division of Plastic and Reconstructive Surgery, Memorial Sloan-Kettering Cancer Center.

Received for publication November 18, 2013; accepted December 30, 2013.

Disclosure: None of the authors has any conflicts of interest or disclosures.

Babak J. Mehrara, M.D., 1275 York Avenue, Suite MRI 1005, New York, N.Y. 10065,

©2014American Society of Plastic Surgeons