title: Cell-Assisted Lipotransfer Improves Volume Retention in Irradiated Recipient Sites and Rescues Radiation-Induced Skin Changes.
abstract: Radiation therapy is not only a mainstay in the treatment of many malignancies but also results in collateral obliteration of microvasculature and dermal/subcutaneous fibrosis. Soft tissue reconstruction of hypovascular, irradiated recipient sites through fat grafting remains challenging; however, a coincident improvement in surrounding skin quality has been noted. Cell-assisted lipotransfer (CAL), the enrichment of fat with additional adipose-derived stem cells (ASCs) from the stromal vascular fraction, has been shown to improve fat volume retention, and enhanced outcomes may also be achieved with CAL at irradiated sites. Supplementing fat grafts with additional ASCs may also augment the regenerative effect on radiation-damaged skin. In this study, we demonstrate the ability for CAL to enhance fat graft volume retention when placed beneath the irradiated scalps of immunocompromised mice. Histologic metrics of fat graft survival were also appreciated, with improved structural qualities and vascularity. Finally, rehabilitation of radiation-induced soft tissue changes were also noted, as enhanced amelioration of dermal thickness, collagen content, skin vascularity, and biomechanical measures were all observed with CAL compared to unsupplemented fat grafts. Supplementation of fat grafts with ASCs therefore shows promise for reconstruction of complex soft tissue defects following adjuvant radiotherapy.
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine.
authors.forename: Anna
authors.initials: A
authors.lastname: Luan
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine.
authors.forename: Dominik
authors.initials: D
authors.lastname: Duscher
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine.
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Whittam
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Paik
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine.
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Zielins
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Brett
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine.
authors.forename: David A
authors.initials: DA
authors.lastname: Atashroo
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Hu
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine.
authors.forename: Gordon K
authors.initials: GK
authors.lastname: Lee
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine.
authors.forename: Geoffrey C
authors.initials: GC
authors.lastname: Gurtner
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine.|Institute for Stem Cell Biology and Regenerative Medicine, Stanford University, Stanford, California, USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Longaker
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine.
authors.forename: Derrick C
authors.initials: DC
authors.lastname: Wan
mesh_terms: D017667:Adipocytes / Q000637:transplantation*; D000818:Animals; D005355:Fibrosis / Q000473:pathology / Q000628:therapy*; D006085:Graft Survival; D006801:Humans; D051379:Mice; D055806:Microvessels / Q000473:pathology / Q000528:radiation effects; D011878:Radiotherapy / Q000009:adverse effects; D012867:Skin / Q000473:pathology / Q000528:radiation effects; D017154:Stromal Cells / Q000637:transplantation*
keywords: Adipose-derived stem cells; Adipose-derived stromal cells; Cell-assisted lipotransfer; Fat grafting; Irradiation; Radiation fibrosis