Abstract:
Autologous fat transplantation -i.e., lipofilling- has become a promising and popular technique in aesthetic and reconstructive surgery with several application such as breast reconstruction, facial and hand rejuvenation. However, the use of this technology is still limited due to an unpredictable and low graft survival rate (which ranges from 25%-80%). A systematic literature review was performed by thoroughly searching 12 terms using the PubMed database. The objective of this study is to present the current evidence for the efficacy of adjuvant regenerative strategies and cellular factors, which have been tested to improve fat graft retention. We present the main results (fat retention rate, histological analysis for pre-clinical studies and satisfaction/ complication for clinical studies) obtained from the studies of the three main fat grafting enrichment techniques: platelet-rich plasma (PRP), the stromal vascular fraction (SVF) and adipose-derived stem cells (ADSCs) and discuss the promising role of recent angiogenic cell enrichment that could induce early vascularization of fat graft. All in all, adding stem or progenitor cells to autologous fat transplantation might become a new concept in lipofilling. New preclinical models should be used to find mechanisms able to increase fat retention, assure safety and transfer these technologies to a good manufacturing practice (GMP) compliant facility, to manufacture an advanced therapy medicinal product (ATMP).
摘要:
自体脂肪移植-即充脂-已成为一种有希望和流行的技术,在美学和重建手术与几个应用,如乳房重建,面部和手部年轻化。然而,由于不可预测且移植物存活率低(25%-80%),该技术的使用仍然受到限制。通过使用PubMed数据库彻底搜索12个术语,进行了系统的文献综述。这项研究的目的是提出目前的证据,辅助再生策略和细胞因子的有效性,已经过测试,以改善脂肪移植物的保留。我们提出了主要结果(脂肪保留率,临床前研究的组织学分析和临床研究的满意度/并发症)从三种主要的脂肪移植富集技术的研究中获得:富血小板血浆(PRP),基质血管部分(SVF)和脂肪来源的干细胞(ADSC),并讨论了最近的血管生成细胞富集可诱导脂肪移植物早期血管化的有希望的作用。总而言之,在自体脂肪移植中添加干细胞或祖细胞可能成为脂肪填充的新概念。应该使用新的临床前模型来寻找能够增加脂肪保留的机制,确保安全性并将这些技术转移到符合良好生产规范(GMP)的设施,制造先进的治疗药物产品(ATMP)。