The Fate of Nonvascularized Fat Grafts

Sunaga, Ataru; Sugawara, Yasuhiko; Tomioka, Yoko; Kobayashi, Eiji

doi:10.1097/gox.0b013e3182a7e827

Cited by 34 publications

(12 citation statements)

References 26 publications

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“…25 Since AFT remains a nonvascularized transplant, defect size plays a dominant role in these considerations. 26,27 Furthermore, a positive effect of AFT on the patient's pain level during the hospital stay was demonstrated. This is in line with the results of previous studies.…”

Section: Discussionmentioning

confidence: 88%

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Long-term Results After Autologous Fat Transfer for Treatment of Chronic Lower Extremity Wounds

Eschborn

Kruppa

Georgiou

et al. 2021

The International Journal of Lower Extremity Wounds

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Autologous fat transfer may offer a simple and effective treatment option for chronic wound patients, delivering adipose-derived stem cells, with potent regenerative attributes. Nevertheless, the clinical benefit has not yet been sufficiently demonstrated. A total of 39 wound patients were treated with autologous fat transfer (AFT) and matched with a control group, according to the identified confounding variables “gender” and “method of defect closure.” All data were acquired retrospectively. Primary outcome was “wound closure” and “reduction of wound size.” After a follow-up of 48 weeks, there was no significant difference in primary outcome (wound closure P = .54) between both groups. The relative wound reduction after fat transfer was 69.9% ± 42.7% compared to 53.4% ± 106.8% in the control group ( P = .91). Subgroup analysis of all patients, healed by secondary intention, revealed an increased wound size reduction ( P = .03) and wound closure rate ( P = .20) in the case group after 12 weeks. No adverse events were recorded. Fat grafting can reduce the wound size if left to secondary healing and may be considered individually for reconstructive purposes. A repeated application of autologous fat might be beneficial due to a temporary effect.

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Section: Discussionmentioning

confidence: 88%

“…25 Since AFT remains a nonvascularized transplant, defect size plays a dominant role in these considerations. 26,27…”

Section: Discussionmentioning

confidence: 99%

Long-term Results After Autologous Fat Transfer for Treatment of Chronic Lower Extremity Wounds

Eschborn

Kruppa

Georgiou

et al. 2021

The International Journal of Lower Extremity Wounds

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“…Large lipid droplets formed in mature adipocytes. However, mechanical damage to brittle adipocytes during fat transplantation and the lack of adequate blood and oxygen supply to the grafts during the early stage after fat grafting induced adipocyte necrosis and another wave of oil release ( Eto et al, 2012 ; Sunaga et al, 2013 ). Next, massive oil droplets get instantaneously accumulated in the fat grafts, causing oil aggregation beyond the scrapable capacity and the formation of oil cysts.…”

Section: Discussionmentioning

confidence: 99%

A Short-Term High-Fat Diet Improved the Survival of Fat Grafts in Mice by Promoting Macrophage Infiltration and Angiogenesis

Niu

Lai

Chen

et al. 2022

Front. Cell Dev. Biol.

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Background: Adipose tissue is an ideal filler material that is widely used for soft tissue defects. But the low survival rate and complications associated with such grafts pose a serious challenge, which limits their clinical application. Adipose tissue is a metabolic diet-responsive tissue; however, the influence of diets on fat grafting remains ambiguous.Methods: We extracted inguinal fat pads from C57/BL6 male mice, and transplanted them into the dorsal region of recipient mice (0.3 ml). Post-fat-grafting, mice (n = 54) were randomized into three groups, namely normal diet (ND), high carbohydrate diet (HC), and high-fat diet (HF). Structural changes were assessed by histological staining. Lipolysis activity and vascular regeneration of grafts on day 30 were analyzed using real-time polymerase chain reaction, immunofluorescence, and western blotting.Results: The grafts of mice on HC and HF diets exhibited significantly fewer oil cysts and larger volume retention (0.18 ± 0.01, 0.21 ± 0.01, and 0.25 ± 0.01 ml, for ND, HC, and HF group, respectively, p < 0.05) on day 90. In comparison, grafts for the mice belonging to the HF groups exhibited higher expression of lipolysis-related genes, including adipose triglyceride lipase (ATGL), hormone-sensitive lipase (HSL), and carnitine palmitoyltransferase 1 (CPT1), on day 30. Furthermore, increased infiltration of macrophages (F4/80+) and the higher expression of angiogenesis genes were reported in the HF groups.Conclusion: Altogether, the administration of short-term HF diet remarkably enhanced angiogenesis and improved the quality of fat grafts, which was characterized by fewer oil cysts and higher long-term volume retention. The possible mechanisms may be due to the increased macrophage infiltration, and the promoted angiogenesis in HF grafts.

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“…In addition to neovascularization, the importance of adipogenesis for long-term retention of transplanted fat has been implicated. Previous in vivo studies have demonstrated that the majority of adipocytes in free grafts die shortly after transplantation, whereas only ADSCs survive ( 7 , 36 , 37 ). In the ‘three zone’ theory suggested by Yoshimura et al ( 38 ), the survival of fat grafts is largely dependent on adipose tissue regeneration post-transplantation, and CD34-positive cells are very likely the seed cells for adipogenic progression.…”

Section: Discussionmentioning

confidence: 99%

Bone marrow mesenchymal stem cell-derived extracellular vesicles improve the survival of transplanted fat grafts

Huang

Feng

Zhang

et al. 2017

Molecular Medicine Reports

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Autologous fat grafting is a promising surgical technique for soft tissue augmentation, reconstruction and rejuvenation. However, it is limited by the low survival rate of the transplanted fat, due to the slow revascularization of such grafts. Previous studies have demonstrated that bone marrow mesenchymal stem cell-derived extracellular vesicles (BMSC-EVs) are proangiogenic. The present study aimed to investigate whether BMSC-EVs could improve the survival of transplanted fat grafts. Extracellular vesicles were isolated from the supernatant of cultured rat bone marrow mesenchymal stem cells, and characterized by flow cytometry and scanning electron microscopy. Their proangiogenic potential was measured in vitro using tube formation and cell migration assays. Subsequently, human fat tissue grafts, alongside various concentrations of BMSC-EVs, were subcutaneously injected into nude mice. A total of 12 weeks following transplantation, the mice were sacrificed and the grafts were harvested. The grafts from the experimental group had a higher survival rate and an increased number of vessels compared with grafts from the control group, as demonstrated by tissue volume, weight and histological analyses. Reverse transcription-quantitative polymerase chain reaction analysis indicated that the expression levels of proangiogenic factors were increased in the experimental group compared with in the control group, thus suggesting that BMSC-EVs may promote neovascularization by stimulating the secretion of proangiogenic factors. The present study is the first, to the best of our knowledge, to demonstrate that supplementation of fat grafts with BMSC-EVs improves the long-term retention and quality of transplanted fat.

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The Fate of Nonvascularized Fat Grafts

Cited by 34 publications

References 26 publications

Long-term Results After Autologous Fat Transfer for Treatment of Chronic Lower Extremity Wounds

Long-term Results After Autologous Fat Transfer for Treatment of Chronic Lower Extremity Wounds

A Short-Term High-Fat Diet Improved the Survival of Fat Grafts in Mice by Promoting Macrophage Infiltration and Angiogenesis

Bone marrow mesenchymal stem cell-derived extracellular vesicles improve the survival of transplanted fat grafts

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