Preparation, Characterization, and Clinical Implications of Human Decellularized Adipose Tissue Extracellular Matrix (hDAM): A Comprehensive Review.
Fat grafting is commonly employed by plastic and reconstructive surgeons to address contour abnormalities and soft-tissue defects; however, because retention rates and thus volume filling effects are unpredictable, there is a search for new and innovative approaches. Initial studies on the use of human decellularized adipose tissue extracellular matrix (hDAM) show promise for its use not only in tissue engineering, but also in fat grafting. In this review, we examine and analyze the literature for the preparation, characterization, and use of hDAM and its derivatives in tissue engineering and plastic surgery applications. All studies reviewed involve physical, chemical, and/or biological treatment stages for the preparation of hDAM; however a distinction should be made between detergent and nondetergent-based processing, the latter of which appears to preserve the native integrity of the hDAM while most-efficiently achieving complete decellularization. Methods of hDAM characterization vary among groups and included simple and immunohistochemical staining, biochemical assays, 3-dimensional (3D) imaging, and mechano-stress testing, all of which are necessary to achieve a comprehensive description of this novel tissue. Finally, we examine the various preclinical models utilized to optimize hDAM performance, which primarily include the addition of adipose-derived stem cells or cross-linking agents. Overall, hDAM appears to be a promising adjunct in fat-grafting applications or even possibly as a stand-alone soft-tissue filler with off-the-shelf potential for commercial applications.
Dr Banyard is a Post-Doctoral Research Fellow and California Institute for Regenerative Medicine (CIRM) Clinical Fellow, Mr. Amezcua is an Undergraduate Student Research Assistant, and Dr Widgerow is Director and Clinical Professor, The Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine. Dr Borad is a Plastic Surgery Resident, Department of Surgery, University of Minnesota, Minneapolis, Minnesota. Dr Wirth is a Professor and Dr Evans is Chairman and a Professor, Department of Plastic Surgery, University of California, Irvine.
Derek A
DA
Banyard
Dr Banyard is a Post-Doctoral Research Fellow and California Institute for Regenerative Medicine (CIRM) Clinical Fellow, Mr. Amezcua is an Undergraduate Student Research Assistant, and Dr Widgerow is Director and Clinical Professor, The Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine. Dr Borad is a Plastic Surgery Resident, Department of Surgery, University of Minnesota, Minneapolis, Minnesota. Dr Wirth is a Professor and Dr Evans is Chairman and a Professor, Department of Plastic Surgery, University of California, Irvine.
Vedant
V
Borad
Dr Banyard is a Post-Doctoral Research Fellow and California Institute for Regenerative Medicine (CIRM) Clinical Fellow, Mr. Amezcua is an Undergraduate Student Research Assistant, and Dr Widgerow is Director and Clinical Professor, The Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine. Dr Borad is a Plastic Surgery Resident, Department of Surgery, University of Minnesota, Minneapolis, Minnesota. Dr Wirth is a Professor and Dr Evans is Chairman and a Professor, Department of Plastic Surgery, University of California, Irvine.
Eduardo
E
Amezcua
Dr Banyard is a Post-Doctoral Research Fellow and California Institute for Regenerative Medicine (CIRM) Clinical Fellow, Mr. Amezcua is an Undergraduate Student Research Assistant, and Dr Widgerow is Director and Clinical Professor, The Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine. Dr Borad is a Plastic Surgery Resident, Department of Surgery, University of Minnesota, Minneapolis, Minnesota. Dr Wirth is a Professor and Dr Evans is Chairman and a Professor, Department of Plastic Surgery, University of California, Irvine.
Garrett A
GA
Wirth
Dr Banyard is a Post-Doctoral Research Fellow and California Institute for Regenerative Medicine (CIRM) Clinical Fellow, Mr. Amezcua is an Undergraduate Student Research Assistant, and Dr Widgerow is Director and Clinical Professor, The Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine. Dr Borad is a Plastic Surgery Resident, Department of Surgery, University of Minnesota, Minneapolis, Minnesota. Dr Wirth is a Professor and Dr Evans is Chairman and a Professor, Department of Plastic Surgery, University of California, Irvine.
Gregory R D
GR
Evans
Dr Banyard is a Post-Doctoral Research Fellow and California Institute for Regenerative Medicine (CIRM) Clinical Fellow, Mr. Amezcua is an Undergraduate Student Research Assistant, and Dr Widgerow is Director and Clinical Professor, The Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine. Dr Borad is a Plastic Surgery Resident, Department of Surgery, University of Minnesota, Minneapolis, Minnesota. Dr Wirth is a Professor and Dr Evans is Chairman and a Professor, Department of Plastic Surgery, University of California, Irvine.
Alan D
AD
Widgerow
D000273:Adipose Tissue / Q000637:transplantation*; D003357:Cosmetic Techniques / Q000009:adverse effects; D005109:Extracellular Matrix / Q000637:transplantation*; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*; D014182:Transplantation, Autologous; D016896:Treatment Outcome