title: Remote Ischemic Preconditioning Recipient Tissues Improves the Viability of Murine Fat Transfer.
abstract: BACKGROUND
  Local ischemia before the development of recipient circulation may contribute to the highly variable long-term results of fat grafting. Remote ischemic preconditioning before adipose procurement augments the retention of fat grafts and limits subsequent liposclerosis. However, there is no literature examining what role remote ischemic preconditioning has on the fat graft recipient site.
  
  
  METHODS
  Subcutaneous adipose tissue from transgenic mice expressing green fluorescent protein/luciferase was injected into skin folds of wild-type mice. Donors and recipients experienced intermittent temporary hindlimb tourniquet application before harvest and transfer, respectively. The viability of the transferred tissue was examined over 28 days by luciferin bioluminescence and subsequent histologic analysis.
  
  
  RESULTS
  There was a difference in bioluminescence at days 0, 14, and 28. The remote ischemic preconditioning donor or recipient mouse-alone groups demonstrated an approximately 2- to 3-fold increase in bioluminescence. Donor and recipient remote ischemic preconditioning had a 9-fold increase in bioluminescence. Histologic analysis at 28 days confirmed the presence of donor adipocytes, and they were gradually replaced by recipient inflammation and scar tissue. However, the amount of interstitial fibrosis was substantially less in the remote ischemic preconditioning groups. These findings were more pronounced when remote ischemic preconditioning was used for both donor and recipient mice.
  
  
  CONCLUSIONS
  Remote ischemic preconditioning has the ability to increase the viability of donor adipocytes and limit interstitial fibrosis. More specifically, remote ischemic preconditioning treatment of both donated adipose tissue and recipient wound beds demonstrates the greatest overall adipose cellular viability and native architecture.
authors.affiliation: Dallas, Texas; and Los Angeles, Calif.|From the Department of Plastic Surgery, University of Texas Southwestern Medical Center; the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California, Los Angeles David Geffen School of Medicine; and the Department of Pathology, Greater Los Angeles VA Healthcare System.
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Gassman
authors.affiliation: Dallas, Texas; and Los Angeles, Calif.|From the Department of Plastic Surgery, University of Texas Southwestern Medical Center; the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California, Los Angeles David Geffen School of Medicine; and the Department of Pathology, Greater Los Angeles VA Healthcare System.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Lewis
authors.affiliation: Dallas, Texas; and Los Angeles, Calif.|From the Department of Plastic Surgery, University of Texas Southwestern Medical Center; the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California, Los Angeles David Geffen School of Medicine; and the Department of Pathology, Greater Los Angeles VA Healthcare System.
authors.forename: Justine C
authors.initials: JC
authors.lastname: Lee
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000818:Animals; D004195:Disease Models, Animal; D005500:Follow-Up Studies; D006085:Graft Survival / Q000502:physiology*; D019194:Ischemic Preconditioning / Q000379:methods*; D051379:Mice; D008822:Mice, Transgenic; D019651:Plastic Surgery Procedures / Q000379:methods*; D015427:Reperfusion Injury / Q000517:prevention & control*; D013997:Time Factors