Sunday, October 8, 2006

Viability of Autologous Fat Grafts Harvested with the Coleman Technique and LipiVage System: A Controlled Study

Lee L. Q. Pu, MD, PhD, FACS, Sydney R. Coleman, MD, Robert Edward H. Ferguson, Jr, MD, Xiangdong Cui, MD, and Henry C. Vasconez, MD.

Introduction: To obtain long term survival of autotransplanted fatty tissue, the newly harvested and refined fat grafts must be viable before implantation. However, the viability of fat grafts harvested and refined by different techniques remains poorly studied and understood. This study is designed to determine the viability of fat immediately after harvesting and refinement. Two different techniques are compared: the Coleman method using a syringe, cannula, and centrifuge and the LipiVage® system, a newly developed harvesting and refining device.

Methods: Eight adult Caucasian females (Ages: 23 to 57 years) were enrolled in this self- controlled, IRB approved study. In each patient, 5 cc of fat grafts were harvested with Coleman technique by a single surgeon (SRC) from the right side of the lower abdomen according to his well described and commonly used method (Group 1, N=8) and additional 5 cc of fat grafts were harvested with the LipiVage® system by a single surgeon (LLQP) from the left side of the lower abdomen following the exact instruction by the manufacture.(Group 2, N=8) All fat graft samples were analyzed within 30 minutes after they were harvested for the following studies: Trypan blue vital staining after collagenase degradation for viable fatty cell counts, glycerol-3-phophatase dehydrogenase (G3PDH) assay as an indicator of intracellular enzyme activity of fatty tissue for determination of viable fat grafts, and routine histology for morphology of harvested fat grafts. The data obtained from this study was analyzed with a two-tail paired Student t-test by our statistician.

Results: There was a slight increase of viable fatty cell counts in Group 1 compared with Group 2.(4.11 ± 1.11 vs. 3.7 ± 0.64 x 1,000,000 Cells/ml, Mean ± SD) However, the difference between the two groups was not statistically significance. (p=0.13) There was a marginally significant increase of the G3PGH activity in Group 1 compared with Group 2.(0.66 ± 0.09 vs. 0.60 ± 0.10 u/ml, p=0.087) Histologically, the normal structure of fragmental fatty tissues was found primarily in both groups.

Conclusions: Our results from this well-controlled preliminary study indicate that autologous fat grafts harvested with LipiVage system have a normal histology with near the same number of viable fatty cells as compared with the Coleman technique. However, these fat grafts appear to have a less optimal level of adipocyte specific enzyme G3PDH activity compared with the Coleman fat grafts. Modifying the LipiVage® system so that the newly harvested adipose tissue can sustain a more optimal level of intracellular enzyme activity might be an important consideration if the system is to be used as a preferred method for fat graft harvesting.

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