Synergistic Effect of Stromal Vascular Fraction and Lymph Node Transfer in a Rabbit Hindlimb Model

Area of Science:

• Regenerative Medicine
• Vascular Biology
• Lymphedema Treatment

Background:

• Adipose-derived stem cells (ADSCs) promote lymphangiogenesis, but their use with vascularized lymph node transfer (VLNT) is underexplored.
• Stromal vascular fraction (SVF) offers an intraoperative alternative to cultured ADSCs, suitable for single-stage VLNT procedures.
• This study investigates the synergistic effects of combined VLNT and SVF therapy in a rabbit hindlimb lymphedema model.

Purpose of the Study:

• To evaluate the impact of combining SVF therapy with VLNT in a single surgical procedure.
• To assess the therapeutic efficacy of combined VLNT and SVF on lymphedema in a rabbit model.
• To determine the effects on lymph node viability, structural integrity, and molecular markers.

Main Methods:

• New Zealand white rabbits were assigned to control, VLNT only, SVF only, or combined VLNT plus SVF groups.
• VLNT involved transferring a pedicled lymph node flap; SVF was injected into perinodal tissue.
• Assessments included edema volume measurement, ICG lymphography, histology, and VEGF-C/LYVE-1 expression analysis.

Main Results:

• Combined VLNT plus SVF significantly reduced hindlimb edema by week 4 compared to controls.
• Histology revealed superior lymph node structural integrity and reduced fibroadipose tissue in the combined group.
• Elevated VEGF-C was observed in SVF-treated groups, with increased LYVE-1 expression in the combined group by week 8.

Conclusions:

• SVF can be effectively integrated with VLNT in a single-stage procedure, enhancing vascularized lymph node viability.
• The combined approach shows potential for improving structural integrity and therapeutic outcomes in advanced lymphedema.
• Further clinical trials are warranted to explore this promising therapeutic strategy.