The autologous adipose stromal vascular fraction (SVF) procedure involves obtaining fat (adipose) tissue-derived stem cells, which are used in various autoimmune, urologic, neurologic, pulmonary, ophthalmologic and orthopedic applications for patients. For orthopedic conditions, adipose-derived stromal vascular fraction (collection of stem cells) is being used in patients with ligament/tendon injuries, chondromalacia, osteoarthritis (OA), osteonecrosis of the femoral head, back/neck pain and more.
The stromal vascular fraction is a by-product of liposuction of excess fatty tissue. This fraction contains a large number of stem cells, termed adipose derived stem cells. These cells are similar to those derived from bone marrow in that they are capable of multilineage differentiation. The SVF of adipose tissue is a potent source of preadipocytes, mesenchymal stem cells, T cells, B cells, endothelial progenitor cells, and adipose tissue macrophages.
The Cell Surgical Network IRB-approved procedure yields 10 million to 40 million stem cells. After harvesting the cells are either immediately used for banked in a CSN afilliate stem cell bank. The cells are cryopreserved for future use and expanded to hundreds of millions of autologous stem cells.
The stem cell procedure itself requires 4 -5 hours. First, the doctor will administer a twilight anesthetic, and then make a small incision in an area of the body with fatty tissue, such as buttocks or stomach. Approximately 100 – 200 mL of adipose tissue will be harvested via liposuction.
Next, the stromal vascular fraction with adult stem cells is separated from the fat cells, macrophages, and additional tissue components via centrifugation. The stem cells from the SVF are then isolated using multi-filtration protocols.
After the stem cells have been isolated they are added to the patient’s platelet-rich plasma and the entire solution is activated with a low light laser.
Finally, the stem cell solution is administered to the patient. Alternatively, if stem cells are acquired for banking purposes they are transferred to a stem cell bank.
Stem cells are categorized by two major types: embryonic stem cells (ESCs) and adult stem cells (ASCs). Adult stem cells can be further divided into non-cultured expanded forms, such as mesenchymal stem cells (MSCs) and autologous stromal vascular fraction.
Musculoskeletal damage, degeneration, and injuries are common health problems. Stem cells of a regenerative potential for damaged and injured tissue. Adipose SVF is use for many orthopedic applications in the clinical setting. These types of stem cells differentiate into cartilage and bone tissue, which is proven in many clinical studies. ASCs in the form of SVF possibly work by secreting cytokines, chemokines, and growth factors, which stimulate healing and tissue regeneration.
To obtain adipose autologous SVF, liposuction is performed. After you are positioned on the procedure table, and the skin is cleaned using an antiseptic. After numbing the area using a local anesthetic, the Chicago stem cell doctor makes a small incision at the abdomen or other body area. A small cannula is inserted, and the adipose cells are gently removed via suction. Once obtained, the solution (called lipoaspirate) is taken to the laboratory for processing, and the incision is closed with Steri-Strips or a Band-Aid.
The lipoaspirates (fat tissue components removed by aspiration) are digested with collagenase solution, which breaks down the matrix. The MSCs are released from the tissue. After being processed through centrifugation (spinning) and dilution, the ASCs are washed and isolated. The cells are processed again 3-4 times, and the end product is the SVF.
In adipose tissue, the number of stem cells derived as SVF can vary. The number of cells range from 500,000 to 2 million cells per gram of adipose tissue, and 1-10% of these cells are adult stem cells (around 4,000-200,000 in quantity). However, a high dose or prolonged exposure to collagenase may damage or kill some stem cells, so the laboratory must be careful with this product.
Current clinical procedures using autologous adipose SVF include:
Current researchers have found that most of the injected SVF fluid is reabsorbed within 2-4 days following the injection. ASCs attach to the lesion, however, and survive a prolonged amount of time. Adipose-derived SVFs offer many other cells in addition to MSCs. They have red blood cells, adipocytes, and white blood cells, which work together to heal the treated structure.
Ichim TE, et al. (2010). Autologous stromal vascular fraction cells: a tool for facilitating tolerance in rheumatic disease. Cell Immunol, 264(1):7–17.
Pak J, Lee JH, Park KS, et al. (2017). Current use of autologous adipose tissue-derived stromal vascular fraction cells for orthopedic applications. Journal of Biomedical Science, 24, 9.
Riordan NH, et al. (2009). Non-expanded adipose stromal vascular fraction cell therapy for multiple sclerosis. J Translational Med, 7:29.