Why adipose-derived stem cells?

So why do we take stem cells from fat?

First, fat (or adipose tissue) contains stem cells that are capable of developing into a variety of cell types.  This is called multilineage differentiation capacity.  The stem cells can turn into bone, cartilage, cardiac muscle, skeletal muscle, nerve tissue, and even blood vessels. That ability makes these cells useful in a multitude of treatment scenarios, for many types of disease processes.  Specifically, these cells work for orthopedic injuries because they can help regenerate bone, cartilage, ligament, and/or tendon, while also helping to provide new vascular supply to the injured area.

Secondly, these cells are rather easily obtained, and in large numbers.The process of tumescent liposuction has minimal morbidity and is relatively benign for the patient.  The alternative is obtaining stem cells from bone marrow, a procedure that involves punching a hole through the bone, usually in the hip, and then extracting marrow from the inner space of the bone.  This can be quite uncomfortable, and requires a larger incision.

Lastly, fat seems to result in an overall larger number of viable stem cells than bone marrow.  This is important in that this higher cell count could result in more viable cells being used in the treatment area, with a potentially greater chance of a beneficial outcome.

(For those interested, the first two points are mentioned in a review article published in 2005 titled Multipotential differentiation of adipose-derived stem cells, by Strem, et. al.  The last point comes from independent research from a group in Florida that has studied stem cells from both fat and marrow.)

Because of these things, our first choice is to obtain cells from fat when possible, using bone marrow aspiration as a back-up plan.  And it is usually possible to get enough adipose tissue from patients in the general population, as we do not need a large amount.

The stem cells are isolated from the adipose tissue by tissue washing and enzymatic digestion, and separated from other cellular material via a centrifuge.  The preparation can take 1.5 to 2 hours, after the actual liposuction procedure that can take an hour or more. Thus, this is a same-day procedure, with minimal discomfort and essentially no down time.