Cell-Assisted Lipotransfer: Supportive Use of Human Adipose-Derived Cells for Soft Tissue Augmentation with Lipoinjection

Department of Plastic Surgery, University of Tokyo School of Medicine, Tokyo, Japan.
Tissue Engineering (Impact Factor: 4.25). 01/2007; 12(12):3375-82. DOI: 10.1089/ten.2006.12.3375
Source: PubMed


Injective transfer of autologous aspirated fat is a popular option for soft tissue augmentation, but several issues require attention, including unpredictability and a low survival rate due to partial necrosis. In this study, histologic features and yield of adipose-derived stromal (stem) cells (ASCs) were compared between human aspirated fat and excised whole fat. Aspirated fat contained fewer large vascular structures, and ASC yield was lower in aspirated fat. Aspirated fat was transplanted subcutaneously into severe combined immunodeficiency mice with (cell-assisted lipotransfer; CAL) or without (non-CAL) vascular stromal fractions containing ASCs isolated from adipose tissue. The CAL fat survived better (35% larger on average) than non-CAL fat, and microvasculature was detected more prominently in CAL fat, especially in the outer layers. DiI-labeled vascular stromal fraction cells were found between adipocytes and in the connective tissue in CAL fat, and some of these cells were immunopositive for von Willebrand factor, suggesting differentiation into vascular endothelial cells. Another experiment that used vascular stromal fractions taken from green fluorescent protein rats also suggested that ASCs differentiated into vascular endothelial cells and contributed to neoangiogenesis in the acute phase of transplantation. These findings may partly explain why transplanted aspirated fat does not survive well and suggest clinical potential of the CAL method for soft tissue augmentation.

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Available from: Tomokuni Shigeura, Oct 10, 2015
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    • "The CAL fat survived better (35 % larger on average) than non-CAL fat, and microvasculature was detected more prominently in CAL fat [93]. The study also confirmed that some of the ADSCs differentiated into vascular endothelial cells being immunopositive for Von Willebrand Factor, which could have contributed to neoangiogenesis in the acute phase of the transplantation [93]. Similarly, Lu et al. reported that fat grafts implanted in the subcutaneous tissue of 18 nude mice supplemented with ADSCs transduced with vascular endothelial growth factor (VEGF) had better survival than ADSCs free fat grafts over 6 months (74.1 ± 12.6% and 60.1 ± 17.6%, respectively) [94]. "
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    ABSTRACT: Craniofacial malformations, have devastating psychosocial implications for many adults and children and causes huge socioeconomic burden. Currently craniofacial defects require soft tissue transfer, bone grafting techniques or difficult procedures such as microvascular free flaps. Such tissues are often limited in quantity, their harvest causes secondary large donor site defects and they lack the capability to fully restore previous form and function. Stem cell technology is being utilised for various tissue and organs of the body and consequently surgeons are eager to transfer these principles for craniofacial surgery. Adipose derived stem cells (ADSCs) are an exciting stem cell source for craniofacial surgeons due to their easy and painless isolation, relatively large abundance and familiarity with the harvesting procedure. ADSCs also have multiple desirable properties including adipogenic, osteogenic and chondrogenic potential, enhancement of angiogenesis and immunodulatory function. Due to these advantageous characteristics, ASDCs have been explored to repair craniofacial bone, soft tissue and cartilage. The desirable characteristics of ADSCs for craniofacial surgical applications will be explained. We report the experimental and clinical studies that have explored the use of ADSCs for bone, cartilage and soft tissue craniofacial defects. We conclude by establishing the key questions that are preventing the clinical application of ADSCs for craniofacial surgery.
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    • "Plastic surgeons in Korea and Japan have played a leading role in pioneering the use of ASCs because government regulations in these countries are less strict than those in Western nations, enabling primary ASCs to be more liberally applied for clinical treatment (7, 8, 9, 10, 11). Early reports of the clinical application of ASCs have been presented at international meetings, including the IFATS. "
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    • "At present, MSCs are frequently used for soft tissue augmentation . In case of adipose tissue transfer the MSCs have antiinflammatory effects and improve long-term survival of the grafts, reduce postoperative atrophy and resorption of the fat tissue through enhanced angiogenesis and cell self-renewal [29] [30] [31]. "
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