Biologics

Adipose Tissue
What is Adipose Tissue?

Adipose tissue is a heterogeneous biological tissue composed of various cellular components; it provides clinicians with a stem-cell-rich product in the form of a 3D scaffold ¹ ². Concentrated adipose tissue is rich in stem cells which hold the ability to differentiate into different cell types responsible for repair or growth of bone, cartilage, muscle, marrow, tendons or connective tissue.

Composition of 
Adipose Tissue

Mesenchymal Stem Cells (AD-MSCs) - Capable of differentiating into many different cell types responsible for the repair or growth of bone, cartilage, muscle, tendons, ligaments and connective tissue.

Endothelial Cells - Structural components of blood vessels. They are also key players in angiogenesis (vascular cell growth).

Pericytes - Wrap around the endothelial cells of capillaries and blood vessels. They play a critical role in supporting the survival of endothelial cells and the overall process of angiogenesis.

Pre-adipocytes - Progenitor cells that are able to adopt the adipocyte cell fate.

Adipocytes - Store lipids to provide energy.

Hematopoietic-lineage cells - Includes red blood cells, white blood cells and platelets.

Concentrate for the Optimal Fat Graft or Injectate

Concentrated adipose tissue provides a physical scaffold of multiple cellular components, which may be used as a high-quality fat graft or injectate for osteoarthritic conditions ⁴. The benefits of concentrated adipose tissue include a high concentration of MSCs and a minimally invasive process for the removal and collection of stem cells (compared to the removal of bone marrow).

Commonly used applications

After the discovery of adipose tissue's stem-cell rich nature, concentrated adipose tissue is being used increasingly in the following applications ⁴:

  • Orthopedic & Sports Medicine

  • Plastic & Reconstructive Surgery

  • Cosmetic & Aesthetic medicine

Watch the Power of Concentrated Adipose Tissue
Not all Concentrated Adipose Grafts are equal

The quality of adipose tissue graft material is an important consideration before performing any lipograft procedure, as is selecting the proper system for graft preparation. 

 

When selecting an Adipose system, it is important to consider the following items -

1. Retention of Stromal Vascular Fraction
  • Tissue SVF contains the entire adipose tissue microenvironment, including a variety of cell types, such as adipocytes, pre-adipocytes and MSCs. Tissue SVF also contains a structural matrix to which cells can attach, supporting cell viability and proliferation and promoting graft retention ⁵.

2. Removal of Excess Infranatant Fluid
  • Excess infranatant fluid in a graft sample makes it challenging to estimate an accurate graft volume for a procedure, because this fluid is resorbed by the body. In an attempt to account for resorption, physicians typically overfill the treatment site with lipoaspirate, resulting in increased swelling and an undesirable initial aesthetic result. ⁶ ⁷ Removal of excess fluid can minimize the need for overfilling and offer a more predictable aesthetic outcome. ⁸

3. Removal of Excess Oils and Lipids
  • Oils, lipids and cellular debris that are present in lipoaspirate may cause an inflammatory response that prolongs graft healing and can prove toxic to the cellular components of the graft itself. Removal of these materials may promote graft survival. ⁶ ⁸

Product Information
AdiPrep

On Harvest Terumo BCT SmartPrep platform, The AdiPrep® Adipose Transfer System is the most effective means for generating a concentrated fat graft with high stem cell and nucleated cell counts. It increases the potential for graft retention by refining the adipose tissue and completely removing contaminants including fluids, oils and lipids.

References
  1. Gimble JM, Katz AJ, Bunnell BA. Adipose-derived stem cells for regenerative medicine. Circ Res. 2007;100(9):1249-1260.

  2. Bourin P, Bunnell BA, Casteilla L, et al. Stromal cells from the adipose tissue-derived stromal vascular fraction and culture expanded adipose tissue-derived stromal/stem cells: a joint statement of the International Federation for Adipose Therapeutics and Science (IFATS) and the International Society for Cellular Therapy (ISCT). Cytotherapy. 2013;15(6):641-648.

  3. SundarRaj S, Deshmukh A, Priya N, Krishnan VS, Cherat M, Majumdar AS. Development of a system and method for automated isolation of stromal vascular fraction from adipose tissue lipoaspirate. Stem Cells Int. 2015. 2015;109353.

  4. Pak J. Regeneration of human bones in hip osteonecrosis and human cartilage in knee osteoarthritis with autologous adipose-tissue-derived stem cells: a case series. J Med Case Rep. 2011 Jul 7;5:296. 

  5. Alexander RW and B Harrell, “Autologous Fat Grafting: Use of Closed Syringe Microcannula System for Enhanced Autologous Structural Grafting.” Clin Cosmet Investig Dermatol 2013; 6: 91–102. 

  6. Hoareau L, Bencharif K, Girard A, et al. Effect of centrifugation and washing on adipose graft viability: a new method to improve graft efficiency. J Plast Reconstr Aesthet Surg. 2013;66(5):712·719.

  7. Sadati K, Alexander R, Corrado A. Platelet-rich plasma (PRP) utilized to promote greater graft volume retention in autologous fat grafting. Am J Cosmet Surg. 2006;23(4):203-211.

  8. Alexander R, Harrell D. Autologous fat grafting: use of closed syringe microcannula system for enhanced autologous structural grafting. Clin Cosmet Investing Dermatol. 2013;6:91-102.