title: The Effects of Fat Harvesting and Preparation, Air Exposure, Obesity, and Stem Cell Enrichment on Adipocyte Viability Prior to Graft Transplantation.
abstract: BACKGROUND
  Adipocyte viability is affected by fat preparation and processing methods, but rigorous and objective studies of these relationships are lacking.
  
  
  OBJECTIVE
  The authors conducted a comprehensive evaluation of variables affecting adipocyte viability prior to injection of fat at the recipient site.
  
  
  METHODS
  Lipoaspirates from 48 patients were processed by high or low vacuum pressure, decantation, electric or manual centrifugation, concentration with cotton gauze, washing, repeated syringe transfer, exposure to lidocaine, and exposure to air. The effects of these variables on adipocyte viability in vitro were ascertained with the MTT assay. The influences of patient obesity (ie, a body mass index [BMI] >30 kg/m2) and enrichment with stem cells on adipocyte viability also were determined.
  
  
  RESULTS
  High vacuum pressure decreased adipocyte viability. Decantation yielded the highest cell viability, followed by washing, concentration with cotton gauze, and centrifugation. Exposure to concentrated lidocaine ambient air exposure, and transfer between syringes significantly decreased viability. Patient obesity was predictive of lower adipocyte viability regardless of processing method, whereas stem cell enrichment significantly improved viability (P < .0001).
  
  
  CONCLUSIONS
  To maximize adipocyte viability, fat should be obtained with dilute local anesthetics and low vacuum pressure, and the lipoaspirate should be maintained in a closed system. To clear cellular debris and blood, the lipoaspirate should be prepared by washing, and the fat should be enriched with adipose stem cells. Decreased adipocyte viability should be expected when fat is harvested from patients with high BMIs.
authors.affiliation: From the Plastic Surgery Division, Hospital Universitario Austral, Buenos Aires, Argentina.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Cucchiani
authors.affiliation: From the Plastic Surgery Division, Hospital Universitario Austral, Buenos Aires, Argentina.
authors.forename: Luis
authors.initials: L
authors.lastname: Corrales
mesh_terms: D017667:Adipocytes / Q000473:pathology / Q000637:transplantation*; D000328:Adult; D000388:Air; D015992:Body Mass Index; D002470:Cell Survival; D002478:Cells, Cultured; D005260:Female; D006801:Humans; D015187:Lipectomy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000473:pathology*; D011446:Prospective Studies; D012307:Risk Factors; D033581:Stem Cell Transplantation; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*; D014182:Transplantation, Autologous; D055815:Young Adult