title: Cell-Assisted Lipotransfer: A Systematic Review of Its Efficacy.
abstract: BACKGROUND
  Autologous lipotransfer is seen as an ideal filler for soft tissue reconstruction. The main limitation of this procedure is the unpredictable resorption and volume loss of the fat graft. In the recent decade, an increasing amount of research has focused on the use of adipose tissue-derived stromal cells (ASCs) to enrich the fat graft, a procedure termed cell-assisted lipotransfer (CAL). The aim of this review was to systematically review the current preclinical and clinical evidence for the efficacy of CAL compared with conventional lipotransfer.
  
  
  METHODS
  A systematic search was performed on PubMed and other databases to identify all preclinical and clinical studies where CAL with ASCs was compared with conventional lipotransfer. A total of 20 preclinical studies and seven clinical studies were included in the review.
  
  
  RESULTS
  The preclinical studies consisted of 15 studies using immunodeficient animal models and five studies using immunocompetent studies. Seventeen studies examined weight/volume retention of which 15 studies favored CAL over conventional lipotransfer. One clinical study did not find any efficacy of CAL and the remaining six studies favored CAL.
  
  
  CONCLUSIONS
  The present evidence suggests that there is a big potential for CAL in reconstructive surgery; however, the present studies are so far still of low quality with inherent weaknesses. Several aspects regarding CAL still remain unknown such as the optimal degree of cell enrichment and also its safety. Further high-quality studies are needed to establish if CAL can live up to its potential.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Odense University Hospital, Odense C, Denmark.
authors.forename: Navid Mohamadpour
authors.initials: NM
authors.lastname: Toyserkani
authors.affiliation: Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense C, Denmark.
authors.forename: Marlene Louise
authors.initials: ML
authors.lastname: Quaade
authors.affiliation: Department of Plastic and Reconstructive Surgery, Odense University Hospital, Odense C, Denmark. jens.sorensen@rsyd.dk.
authors.forename: Jens Ahm
authors.initials: JA
authors.lastname: Sørensen
mesh_terms: D017667:Adipocytes / Q000637:transplantation*; D000273:Adipose Tissue / Q000637:transplantation*; D000818:Animals; D002986:Clinical Trials as Topic; D004195:Disease Models, Animal; D006801:Humans; D019651:Plastic Surgery Procedures / Q000379:methods; D017154:Stromal Cells
keywords: Adipose-derived stromal cell; Cell-assisted lipotransfer; Fat graft; Regenerative medicine; Stromal vascular fraction