Implantation von "Tissue-Engineered-Lymphknoten" unter Verwendung von Polycaprolacton-Gerüstträgern in der immundefizienten Nacktmaus

Treatment of chronic lymphedema is clinically challenging and healing is still only possible in some rare cases. Besides the gold standard of complex decongestive therapy (CDT), reconstructive surgical techniques are used, with microvascular lymph node transplantation the most promising procedure. We introduced the technique, which was first described by Becker et al. several decades ago, in our department in February 2011. The procedure entails harvesting of a fat/lymph node package from the healthy donor site for microsurgical transplantation into the affected recipient site. It is hypothesized that growth factors released by transplanted lymph node tissue induce lymphangiogenesis in the surrounding tissue. One major drawback is the development of iatrogenic lymphedema at the donor site. We use a novel scaffold-based lymph node tissue engineering concept to minimize the surgical risks and simultaneously induce lymph vessel regeneration in the recipient site. For the procedure, a healthy lymph node is surgically harvested and sliced into small fragments. These are combined with fibrin glue and loaded into a polycaprolactone scaffold, which is designed for tissue engineering applications by a 3D printing process (melt electrospinning writing). The cylindrical bio-absorbable scaffold can be used for in vitro cultivation experiments or for immediate in vivo transplantation. Our initial results in the mouse model indicate the development of new lymphatics emerging from the transplant. We demonstrate that lymph node tissue engineering has the potential to become an important foundation for the treatment of chronic lymphedema.