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[自体脂肪移植及脂肪组织基质细胞辅助强化]

[Autologous fat grafts and supportive enrichment with adipose tissue stromal cells].

作者信息

Karagianni M, Kraneburg U, Klüter H, Machens H-G, Bieback K, Schantz J-T, Papadopulos N

机构信息

Institut für Transfusionsmedizin und Immunologie, Medizinische Fakültät Mannheim, Universität Heidelberg; DRK-Blutspendedienst Baden-Württemberg - Hessen.

出版信息

Handchir Mikrochir Plast Chir. 2013 Apr;45(2):93-8. doi: 10.1055/s-0033-1334908. Epub 2013 Apr 29.

Abstract

Liposuction is a most common surgical procedure in aesthetic surgery that aims at the local fat reduction. The obtained adipose tissue is currently used as a biocompatible filler. Autologous fat transplantation, also known as lipofilling, has become an attractive treatment method in the field of aesthetic facial surgery and scar tissue reconstruction. Lipofilling may also offer an alternative method to prosthetic breast surgery. Nevertheless, postoperative fat tissue resorption is still a limitiation to lipofilling in breast reconstruction leading to multiple revisions in order to reach the requested clinical outcome. The therapeutic effect of autologous fat grafts does not solely lie in its role as a filler material, but also in its wound healing and angiogenetic properties. The latter is not attributed to the mature adipocytes, but rather to the undifferentiated adipose derived stromal cells (ASC). Thus enrichment of the fat graft with autologous ASC, known as cell-assisted lipotransfer (CAL) may lead to further optimisation of lipofilling concerning fat graft survival. Still aiming to establish the application of autologous fat grafts and ASC in breast reconstruction, there is a necessity for systematic analyses in order to resolve questions regarding the operational technique and qualitative aspects of the ASC manufacturing in accordance with pharmaceutical guidelines and regulations in Germany. Besides, some open questions need to be addressed regarding the ASC differentiation potential in vivo.

摘要

抽脂术是美容外科中最常见的外科手术,旨在局部减少脂肪。所获取的脂肪组织目前被用作生物相容性填充物。自体脂肪移植,也称为脂肪填充,已成为美容面部外科和瘢痕组织重建领域一种有吸引力的治疗方法。脂肪填充也可能为假体隆胸手术提供一种替代方法。然而,术后脂肪组织吸收仍然是乳房重建中脂肪填充的一个限制因素,这导致需要多次修复才能达到所需的临床效果。自体脂肪移植的治疗效果不仅在于其作为填充材料的作用,还在于其伤口愈合和血管生成特性。后者并非归因于成熟的脂肪细胞,而是归因于未分化的脂肪来源基质细胞(ASC)。因此,用自体ASC富集脂肪移植,即所谓的细胞辅助脂肪移植(CAL),可能会在脂肪移植存活方面进一步优化脂肪填充。仍旨在确立自体脂肪移植和ASC在乳房重建中的应用,有必要进行系统分析,以便根据德国的药品指南和法规解决有关ASC制造的操作技术和质量方面的问题。此外,关于ASC在体内的分化潜能仍有一些悬而未决的问题需要解决。

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