Abstract: Progenitor Cell Mobilization Augments Fat Graft Survival (Plastic Surgery 2010 (October 1-5, 2010))

Sunday, October 3, 2010: 9:55 AM

Metro Toronto Convention Centre

Parag Butala, MD , Institute of Reconstructive Plastic Surgery, New York University Medical Center, New York, NY

Steven M. Sultan, BA , Institute of Reconstructive Plastic Surgery, New York University Medical Center, New York, NY

Edward H. Davidson, MBBS , Institute of Reconstructive Plastic Surgery, New York University Medical Center, New York, NY

James L. Crawford, BS , Institute of Reconstructive Plastic Surgery, New York University Medical Center, New York, NY

Caroline Szpalski, MD , Institute of Reconstructive Plastic Surgery, New York University Medical Center, New York, NY

Denis Knobel, MD , Institute of Reconstructive Plastic Surgery, New York University Medical Center, New York, NY

Alexandre Marchac, MD , Institute of Reconstructive Plastic Surgery, New York University Medical Center, New York, NY

Pierre B. Saadeh, MD , Institute of Reconstructive Plastic Surgery Laboratories, NYU, New York, NY

Stephen M. Warren, MD , Institute of Reconstructive Plastic Surgery Laboratories, NYU, New York, NY

Sydney R. Coleman, MD , Institute of Reconstructive Plastic Surgery, New York University Langone Medical Center, New York, NY

Alexes Hazen, MD , Institute of Reconstructive Plastic Surgery, NYU Langone Medical Center, New York, NY

Introduction: Graft survival of the highest density (HD) and lowest density (LD) centrifuged lipoaspirate appears to be influenced by the quantity of functional adipocytes as well as adipose-derived stem cell concentration. We hypothesize, therefore, that mobilization of endothelial progenitor cells from the bone marrow of recipients leads to improved fat graft survival.

Methods: Male 8-week old FVB mice (n=24) underwent grafting of either 2cc of the highest density (n=12) or 2cc of the lowest density (n=12) human lipoaspirate after centrifugation using a previously established model. The mice received either AMD3100 (10mg/kg i.p. daily for 14 days) or saline. Animals were sacrificed either at 2 weeks or 10 weeks after grafting and fat was harvested for assessment of survival, and analysis by RT-PCR, ELISA, immunohistochemistry, and flow cytometry.

Results: HD grafts with saline demonstrated significantly improved 2- and 10-week graft survival compared to LD grafts (85% vs. 59%, 60% vs. 40%, p<0.05, respectively). LD grafts with AMD3100 treatment demonstrated 2- and 10-week survival comparable to HD grafts (82% vs. 75%, 52% vs. 50%, p>0.05, respectively). Quantitative RT-PCR at 2- and 10-weeks showed double the CD31 expression in low density grafts with AMD3100 (fold change 1.99 +/- 0.15). Protein quantification for VEGF at 2- and 10-weeks showed comparable amounts in treated LD compared to sham-treated HD grafts (0.42pg/ng +/- 0.04 vs. 0.38pg/ng +/- 0.09, p>0.05) while sham-treated LD grafts had significantly less VEGF compared to HD grafts (0.20pg/ng +/- 0.05 vs. 0.40pg/ng +/- 0.07, p<0.05). ELISA for stromal-derived factor-1 (SDF-1) showed similar expression patterns. These results were confirmed with immunohistochemistry for CD31; LD treated grafts demonstrated uptake comparable to HD sham-treated grafts. Isolation of lineage negative cells in harvested grafts additionally demonstrated increased concentration of progenitor cells in treated animals compared to sham-treated animals.

Conclusions: Endothelial progenitor cell supplementation of lipoaspirate improves graft survival and suggests a vasculogenic mechanism that underpins the success in microstructural fat grafting.

18057 Progenitor Cell Mobilization Augments Fat Graft Survival