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Vascularized Lymph Node Transfer

What is a Vascularized Lymph Node Transfer?

For many breast cancer survivors, lymphedema is a frustrating, lifelong reminder of their journey, marked by swelling, discomfort, and daily disruption. Fortunately, there’s advanced surgical options like Vascularized lymph node transfer (VLNT), a highly specialized procedure designed to restore natural lymphatic function and provide long-term relief.

A vascular lymph node transfer, also known as a lymph node transplantation, involves transferring healthy lymph nodes, along with their blood supply, from one part of the body to the affected area. This microsurgical technique helps reestablish lymphatic drainage pathways and reduce swelling, making it especially beneficial for patients who haven’t responded to conservative lymphedema therapy.

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Key Information

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Vascularized lymph node transfers treat chronic lymphedema by restoring lymphatic drainage.
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The typical procedure time is 4–6 hours.
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A hospital stay is usually 2–3 nights.
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Most patients return to light activity within 2–3 weeks; full recovery can take several months.
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Common donor sites include the groin, abdomen, or neck, which are carefully selected to avoid causing swelling in the donor area.

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VLNT can be combined with natural tissue breast reconstruction (e.g., DIEP flap) in select cases.
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A lymph node transplant is ideal for patients with moderate to severe lymphedema who are not responding to therapy or conservative treatments.
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What to Expect During Surgery

Under general anesthesia, your PRMA surgical team will begin by carefully selecting and removing a group of healthy lymph nodes, most commonly from the groin, abdomen, or neck, along with their tiny blood vessels. These donor nodes are chosen with precision to avoid any risk of causing lymphedema in the area from which they’re taken.

Next, the team transfers these lymph nodes to the affected arm or chest area where lymphedema is present. The surgeons meticulously reconnect the blood vessels using advanced microsurgical techniques to ensure proper circulation. This reconnection allows the transplanted nodes to become a functional part of the new location, improving lymphatic flow and reducing swelling.

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Recovery Timeline

  • Week 1:
    After a vascular lymph node transfer, patients typically stay in the hospital for 2–3 nights, where they are monitored closely to ensure the transferred lymph nodes receive proper blood flow. During these first few days, mild to moderate swelling, bruising, and fatigue are common.
  • Week 2:
    By the second week, most patients return home and continue healing with light walking and minimal activity. You’ll likely still feel tired, and donor site discomfort may persist. Continue wearing compression garments as advised, and avoid lifting or strenuous tasks.
  • Week 3-4:
    Energy levels typically improve by the third and fourth week post-surgery, and most patients can return to non-physical work or basic daily routines. While swelling may still be present, discomfort steadily decreases. Depending on your surgeon's recommendation, you may begin light stretching or physical therapy.
  • Week 5-6:
    Your follow-up visit will assess healing and initial results. Many patients begin to notice reduced limb heaviness or slight improvements in swelling. Any lingering tightness or soreness typically resolves by this stage. Some can return to more normal activities with caution.

Am I a Candidate for a Vascularized Lymph Node Transfer?

Like any surgery, not every patient is an ideal match for vascularized lymph node transfer. Several factors, including your overall health, stage of lymphedema, and previous treatments, help determine if this option is right for you. 

You may be a strong candidate for vascularized lymph node transfer if:

  • You have moderate to severe lymphedema that hasn’t improved with therapy or compression alone
  • You’ve had lymph nodes removed due to breast cancer treatment
  • Your lymphedema has persisted for 6 months or longer
  • You’re in generally good health and a non-smoker (or willing to quit)
  • You’re seeking a long-term solution rather than symptom management
  • You’re open to surgical intervention, and the recovery process involved
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Find Your Surgeon

PRMA is the only center in San Antonio, Texas, and one of the few centers worldwide that offers VLNT on such a large scale. Discover why thousands of women travel from across Texas, the US, and the world for lymphedema treatment.
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Dr. Anton Fries
Board-Certified Plastic Surgeon specializing in advanced lymphatic surgery and reconstructive microsurgery

Will Insurance Cover a Vascular Lymph Node Transfer?

A vascularized lymph node transfer is often covered by insurance, especially when it’s deemed medically necessary to treat lymphedema resulting from cancer treatment. 

The insurance specialists at PRMA work closely with patients and insurance providers to verify coverage and maximize benefits. 

For more information, visit our Insurance FAQs in the patient resource center.
Insurance FAQs
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Preparing for Surgery

Many of our patients travel in from all parts of the country for breast cancer surgery and reconstruction. To help you prepare, our team will walk you through every step, from pre-op planning to travel arrangements, to ensure a smooth and supported experience.

Learn more about:
Preparing for Surgery
Travel Accomodations

Frequently Asked Questions

Is a vascular lymph node transfer a cure for lymphedema, or will I still need ongoing treatment?
VLNT is not considered a definitive “cure,” but many patients experience significant improvement in symptoms, reduced swelling, and a decreased need for compression therapy over time. Some may still require occasional maintenance, but the goal is to greatly enhance one’s quality of life long-term.
Can lymph nodes be taken from anywhere, or is there a risk of causing lymphedema in the donor site?
Great care is taken to select donor sites that carry the lowest risk of creating new lymphatic issues. Our surgeons use specialized imaging techniques like reverse lymphatic mapping when appropriate to help avoid harvesting nodes that drain critical areas like the legs.
How does VLNT compare to lymphaticovenous bypass surgery?
While both are surgical treatments for lymphedema, they work differently. Lymphaticovenous bypass connects blocked lymphatic vessels directly to tiny veins to reroute fluid, while VLNT introduces new lymph nodes to restore natural drainage.
Can VLNT be done years after cancer treatment, or is there a time limit?
There’s no strict time limit—VLNT can be performed months or even years after cancer treatment if lymphedema develops or worsens over time.

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