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Stem Cell Therapy Enriched Fat Grafting for the Reconstruction of Craniofacial Deficits
Debra Bourne, MD; Francesco Egro, MD, Jacqueline Bliley, MS; Isaac James, MD; E. Michael Meyer, BA; Vera Donnenberg, PhD; Albert D. Donnenberg, PhD; Barton Branstetter, MD; Kacey Marra, PhD; Sydney Coleman, MD; J. Peter Rubin, MD
University of Pittsburgh Medical Center
2018-01-28
Presenter: Debra Bourne
Affidavit:
This abstract represents original work of the submitting resident, Debra Bourne, and all listed co-authors. This abstract has not been previously presented at a major meeting or published.
Director Name: Vu Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
PURPOSE: Fat grafting is an effective treatment for craniofacial deformities. Stromal vascular fraction (SVF) is a concentrated form of adipose derived stem cells (ASC) that can be isolated from fat through collagenase based procedures. The aim of this clinical trial is to assess the impact of SVF enrichment on craniofacial fat grafting.
METHODS: This IRB-approved prospective cohort study was funded by the Department of Defense. Twelve subjects with at least two regions of craniofacial volume deficit were enrolled and underwent fat grafting with SVF-enriched or standard fat grafting to each area. All patients had bilateral malar regions injected with SVF-enriched graft on one side and control standard fat grafting to the contralateral side. Outcome assessments included: 1) demographic information; 2) volume retention determined by CT scans; 3) SVF cell populations assessed by flow cytometry; 4) SVF cell viability; and, 5) complications. Follow-up was nine months.
RESULTS: All patients had subjective improvement in appearance. There were no serious adverse events. There was no significant difference in volume retention between the SVF-enriched and control regions overall (50.3% vs 57.3%, p=0.269) or comparing malar regions (51.4% vs 56.7%, p=0.494). Patient age, smoking status, obesity, and diagnosis of diabetes did not impact volume retention. Cell viability was 77.4±7.3%. Cellular subpopulations were 60.1±11.2% ASCs, 12.2±7.0% endothelial cells, and 9.2±4.4% pericytes. There was no significant correlation between cell viability or cellular subpopulations and volume retention.
CONCLUSIONS: Autologous fat transfer for reconstruction of craniofacial defects is effective and safe. SVF enrichment does not significantly impact volume retention.
