Scientists say that the first randomized human trial using stem-cell enriched fat grafts for reconstructive surgery shows that the procedure is safe, reliable and effective.
Researchers from the Copenhagen University Hospital in Denmark say the procedure could become central to plastic and reconstructive surgery.
Autologous fat grafting, or lipofilling, is being increasingly used in reconstructive surgery, such as breast reconstruction following cancer, the researchers say.
The procedure involves harvesting a patient’s own fat in order to increase the volume of fat in another area of their body.
The researchers point out that the procedure has high resorption rates of up to 80% – the percentage of the transferred fat that does not survive.
But recent animal studies have demonstrated that fat grafts that have been enriched with culture-expanded adipose (fat)-derived stem cells (ASCs) have been shown to significantly improve graft survival.
For their study, published in The Lancet, the researchers carried out the stem-cell fat graft procedure and compared this with the standard autologous procedure in 10 healthy volunteers.
The volunteers underwent liposuction so that fat tissue could be collected from one side of their abdomen.
The researchers then prepared two purified fat grafts for each volunteer, and these were injected into their upper arms. One graft was enriched with the participants’ own stem cells, while the other was not.
Immediately after the procedure and then again after 121 days, the researchers took MRI scans of the volunteers, in order to measure the volumes of the injected fat grafts.
From initial MRI scans, the grafts carried out using the fat-derived stem cells were shown to retain 80.9% of their volume, compared with 16.3% for the standard control grafts.
Furthermore, the ASC grafts revealed significantly higher amounts of adipose tissue and newly formed connective tissue, while showing much less necrosis – the death of body tissue – after 4 months.
Dr. Stig-Frederik Trojahn Kølle, of Copenhagen Univerisy Hospital and author of the study, says:
“These promising results add significantly to the prospect of stem cell use in clinical settings and show that ASC graft enrichment could render lipofilling a reliable procedure, since the resorption rate, quality of tissue, and safety can be predicted.”
Dr. Trojahn Kølle says that stem-cell enriched fat grafting might prove to be an attractive alternative to major tissue augmentation, such as “breast reconstruction after cancer with allogeneic material or major tissue flap surgery, with fewer side effects and more satisfying cosmetic results.”
In a linked comment following the study, J. Peter Rubin and Kacey G. Marra, of the Department of Plastic Surgery at the University of Pittsburgh, note that stem-cell enriched fat grafting could revolutionize reconstructive surgery:
“In recent decades, the standard of care for treating soft tissue deformities has centered on tissue flap procedures and use of prosthetic implants. Although often very effective in restoring the contour of soft tissue, these current therapies are not without problems,” they say.
“The report by Kølle and colleagues provides important data to justify the use of cell-based therapy for injectable soft tissue reconstruction, and lays the foundation for refinement of interventions that can improve outcomes in minimally invasive reconstructive therapies.”
The researchers conclude that further studies are needed in order to apply the ASC grafting method to the relevant patient populations.