Animal Models Used in the Research of Vascularized Lymph Node Transfer: A Systematic Review

Abstract

Background: Lymphedema is a common adverse consequence of breast cancer therapy, while still relatively little is known about its pathophysiology. Several treatment options emerged over the past decades, and among them, vascularized lymph node transfer (VLNT) seems to be particularly promising. Animal models are indispensable to improve our understanding of the underlying processes surrounding the transplantation of a vascularized lymph node. This review aimed to systematically evaluate animal models of VLNT and compare their advantages and disadvantages.

Materials and methods: A systematic review of literature in the Scopus, Web of Science, and Ovid MEDLINE databases was conducted according to the PRISMA guidelines to identify all studies on animal models used for the research of VLNT. The algorithm used in search of articles was "Vascularized Lymph Node Transfer" AND "Model". Articles were manually verified for relevance to the topic. The resulting models were assessed for their suitability for VLNT research.

Results: The literature search yielded a total of 233 studies after duplicates removal. Of those, 217 were excluded based on title and abstract review. Another study was excluded after reviewing the full-text article leaving 15 eligible studies to be included in this review article.

Conclusions: Rats were found to be the most dominantly used animal model in the VLNT research, although other models had their benefits. The main areas of study were the functionality of VLNT within or without a preinduced lymphedema, its response to ischemia, and clarification of lymphatic pathways reestablishment following VLNT.

Keywords: Animal model; Lymphatic system; Lymphedema; Vascularized lymph node transfer.