title: Remote Ischemic Preconditioning Improves the Viability of Donor Lipoaspirate during Murine Fat Transfer.
abstract: BACKGROUND
  Variable results associated with fat grafting have been attributed to local trauma, inconsistencies in transfer, and ischemia before the development of recipient circulation. Remote ischemic preconditioning is an inexpensive noninvasive technique that has been used in animal models and multicenter clinical trials to protect organ systems. In this work, the authors describe a novel animal model for analyzing the efficacy of fat grafting, and investigate the effect of remote ischemic preconditioning on volume retention.
  
  
  METHODS
  Subcutaneous adipose tissue samples from green fluorescent protein/luciferase-expressing FVB mice were obtained with or without pretreatment with a temporary hind-limb tourniquet. The samples were injected into the dorsal skin folds of wild-type FVB mice. The viability of the transferred tissue was examined over a 28-day period with quantitative bioluminescence after luciferin injection. Transferred tissue was also explanted for histologic analysis.
  
  
  RESULTS
  The remote ischemic preconditioning group had significantly increased bioluminescence at days 0, 1, and 28. Histologic analysis at day 28 confirmed the presence of vascularized adipose in both groups. However, significant amounts of interstitial fibrosis were found in the control group, whereas substantially less was found in the remote ischemic preconditioning group. The remote ischemic preconditioning group retained a substantially greater amount of green fluorescent protein, suggesting increased survival of donor adipocytes.
  
  
  CONCLUSIONS
  In this work, the authors describe a novel animal model for quantitative evaluation of fat grafting using in vivo bioluminescence of adipocytes from luciferase-expressing mice. The authors also demonstrate that remote ischemic preconditioning increases the viability of fat transfer and decreases interstitial fibrosis.
authors.affiliation: Los Angeles, Calif.; and Philadelphia, Pa. From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California, Los Angeles, David Geffen School of Medicine; the Department of Pathology, Greater Los Angeles VA Healthcare System; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Temple University Hospital and School of Medicine.
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Gassman
authors.forename: Michael S
authors.initials: MS
authors.lastname: Lewis
authors.forename: James P
authors.initials: JP
authors.lastname: Bradley
authors.forename: Justine C
authors.initials: JC
authors.lastname: Lee
mesh_terms: D000818:Animals; D019194:Ischemic Preconditioning / Q000379:methods*; D015187:Lipectomy; D051379:Mice; D015427:Reperfusion Injury / Q000517:prevention & control*; D050151:Subcutaneous Fat / Q000098:blood supply / Q000637:transplantation*; D014022:Tissue Survival