b"INTRODUCTIONAuthors: Melissa Aldrich, MBA, PhD; LouiseThe human body comprises eleven essential systems Koelmeyer, BAppSc(OT), PhD; Kay Pham, MD;that play critical roles in maintaining overall health, Kimberly Steele, MD, PhD including the circulatory, respiratory, integumentary, endocrine, gastrointestinal (digestive), urinary, musculoskeletal, nervous, reproductive, immune,Welcome to the Standardizedand lymphatic systems. Approach for the Diagnosis andYet the lymphatic system (LS) is the only body system Management of Lymphedema (LE) that currently fails to offer patients early diagnosis and appropriate therapy options that are safe, effective, and Lymphatic Diseases (LD). and tolerable 1 . This paradox has an even greater This comprehensive guide has impact when one considers that the lymphatic system been meticulously crafted bybridges the functionality of two critical componentsto human health, namely, the circulatory and the experts in the field of lymphaticimmune systems. medicine, in collaboration with theThe lymphatic system consists of a complex networkLymphatic Education & Researchof vessels throughout the body as well as primary and secondary lymphatic organs such as the bone marrow, Network (LE&RN).thymus, spleen, lymph nodes, and mucosa-associated lymphatic tissue. The lymphatic system works in We aim to provide healthcare professionals with a conjunction with the blood vasculature playing a key clear and unified framework for the assessment,role in health by returning excess fluids and proteins diagnosis, and treatment of lymphedema (LE) andfrom tissues to the circulation. Fluid (protein, waste, various lymphatic diseases (LD). In doing so, we striveforeign bodies, lipids) that seeps out of the blood to ensure that individuals at risk of or living withvasculature through the capillaries into the interstitial lymphedema or lymphatic diseases across the globespace (the space between cells) must be collectedreceive the highest standard of care, with a focus onby the lymphatic system, which is a one-way systemearly detection, effective intervention, and improvedof vessels starting with terminal lymphatics and quality of life. This document is a product of extensiveprogressing through larger lymphatic vessels to lymph research, clinical expertise, and a shared commitmentnode basins (located throughout the body) and the to advancing the understanding and management lymphatic and thoracic ducts (TD) located in the upper of lymphatic conditions. We invite you to explore chest, where the lymph fluid collected along the route this resource and embrace the opportunity to empties into the venous circulation. enhance the lives of those living with these often- When the lymphatic system is impaired due to underrecognized conditions. congenital anomalies or is secondarily damaged by As the prevalence of lymphedema and lymphatictrauma, cancer, chemotherapy, radiation, or surgical disease continues to rise globally, it becomesinjury, it leads to serious consequences such asincreasingly imperative to establish consistent andedema, lymphedema, and potentially cardiac failure. evidence-based practices for their diagnosis andFurther, immune cells cannot efficiently circulate inmanagement. lymphedema and lymphatic disease,the body to conduct immunologic surveillance, resulting in the affected body part becoming proneoften overlooked in the past, can have profoundto recurrent infection, or cellulitis 2 .effects on an individual's health and well-being.They not only lead to physical symptoms andAn estimated 10 million Americans live with complications but also impose a substantial emotionallymphedema (LE) 3 ; more than human immuno-and economic burden on patients and healthcaredeficiency virus (HIV) 4 , Parkinsons 5 , multiple systems. By implementing standardized protocols sclerosis 6 , muscular dystrophy 7 , and amyotrophic and guidelines, we aim to address these challengeslateral sclerosis (ALS) 8combined. Normal structure comprehensively, ensuring that every patient,and function of the lymphatic system can be alteredregardless of their geographical location or medicalby congenital diseases such as primary lymphedema, provider, receives timely and effective care. Thislymphatic malformations or by trauma, cancer, document represents a significant milestone in ourradiation, or surgical injury resulting in secondary collective journey toward improving the lives of thoselymphedema. Every day, children are born with affected by lymphedema and lymphatic disease. incurable lymphatic anomalies (LA), leading to life-| Standardized Approach for the Diagnosis and Management of Lymphedema (LE) and Lymphatic Diseases (LD)|7"