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Oral, Inactive Vd3 Significantly Improves Autologous Fat Graft Retention In A Swine Model
Andreea Gavrilescu, BA
Amr Elmeanawy, MD
Shawn J Loder, MD
Alexandra Vagonis, BS
Yusuf Surucu, MD
Hamid Malekzadeh, MD
Jose Antonio Arellano, MD
Rachel Ricketts
J. Peter Rubin, MD
Lauren E Kokai, PhD
University of Washington School of Medicine
2024-02-01
Presenter: Andreea Gavrilescu
Affidavit:
This work was a collaboration by all of the authors listed above.
Director Name: Vu Nguyen, MD
Author Category: Medical Student
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction
Introduction
Surgeons apply autologous fat grafting (AFG) to correct soft tissue defects and for tissue
regeneration, but outcomes remain inconsistent. Our previous data showed that VD3, a pleiotropic fat-soluble hormone with angiogenic and anti-inflammatory benefits, significantly improved human fat graft outcomes in a mouse model. This study evaluated oral VD3 for AFG retention in a porcine model.
Methods
Three Yucatan pigs underwent AFG of inguinal adipose into 16 defined dorsal zones, 5cc each. Pig 1 received no medical intervention, Pig 2 received post-surgical oral VD3 thrice weekly (100K IU), and Pig 3 received oral VD3 (100K IU) thrice weekly beginning two weeks pre-operatively and continued post-surgically. Biopsies were collected monthly until sacrifice at 3 months, when all grafts were excised, weighed, and processed for histology. Statistical analyses (ANOVA, post-hoc tests) were performed via GraphPad.
Results
Mean graft retention for Pig 1 was 18.99% (SEM=4.57) versus 40.19% (SEM=5.65) for Pig 2 and 41.98% (SEM=6.57) for Pig 3 (p=0.016, p=0.008). Histologically, graft architecture was similar across study groups, resembling intact adipose with some areas of necrosis, adipocyte loss, small accumulations of free oil, and fibrosis. Histological semi-quantification of macrophages, vasculature, and perilipin+ adipocytes is underway.
Conclusion
Oral VD3 significantly increased fat graft retention compared to no treatment, with no demonstrated benefit for pre-treatment compared to post-surgical supplementation. Given the demonstrated safety profile of VD3, we believe this is a feasible approach to improve fat grafting outcomes. We predict lower doses will be necessary clinically from superior human VD3 metabolism compared to swine.
