MAINTENANCE OF LONG-TERM THORACIC DUCT FISTULAS FOR THE ACHIEVEMENT OF IMMUNOSUPPRESSION IN MAN
Abstract
The achievement of immunosuppression by thoracic duct lymph fistulas requires long-term drainage from one to three months. Manipulation of the immune system during profound lymphocyte depletion, un adulterated by the protean effects of pharmacologic agents, offers a unique opportunity to study and treat auto-immune disease and organ rejection phenomena. The protocol for thoracic duct cannulation and maintenance of long-term fistulas must be rigid ly observed for successful thoracic duct drainage. Surgical technique and important caveats are reviewed.