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Autologus fat transplantation is host compatible, readily available, and can be harvested easily and repeatedly as needed without complication. The main limitation of this procedure was the low survival rate and high resorption rate of the transplanted fat with graft survival rate ranging from 20 to 90 %.
Enriching the transplanted fat with stem cells (cell assisted lipotransfer) or oral administration of alpha-lipoic acid (ALA) before and after graft injection, were thought to increase the survival rate of the transplanted fat. So, the current study was undertaken to compare between cell-assisted lipotransfer (CAL) and ALA therapy in improvement of fat graft survival.
Thirty adult female albino rats weighing about 200-250 gm were used in the current study. They were divided into three groups:
• group I (Control group): consisted of 10 rats which received fat mixed only with saline. Animals were subdivided in to two subgroups:
- subgroup Ia: consisted of 5 rats which were sacrificed after 7 days.
- Subgroup Ib: consisted of 5 rats which were sacrificed after 28 days.• group II (cell assisted lipotransfer group): consisted of 10 rats. Each rat received mixture of 1 mL of minced fat mixed with 300 μL of phosphate-buffered saline (PBS) containing 1 × 105 ASCs. They were subdivided in to two subgroups:
- Subgroup IIa: consisted of 5 rats which were sacrificed after 7 days.
- Subgroup IIb: consisted of 5 rats which were sacrificed after 28 days.
• group III (alpha-lipoic acid group): consisted of 10 rats which received oral ALA treatment(500 mg/kg/day) 4 days before fat transplantation and the treatment continued throughout the experiment. The animals were subdivided into two groups:
- Subgroup IIIa: consisted of 5 rats which were sacrificed after 7 days.
- Subgroup IIIb: consisted of 5 rats which were sacrificed after 28 days.
All animals were sacrificed after anesthesia with ether inhalation. Fat grafts were extracted from sites of injection and processed for light microscopic examination.
Histological evaluation of the fat grafts from animals of control subgroups revealed atrophy and death of adipocytes with formation of numerous fat cysts. Severe inflammatory infiltration with giant cells formation and fibrosis were detected as well.
In CAL subgroups (IIa&IIb) significant increase in number of normal sized adipocytes and VEGF reaction together with significant decrease in inflammation and fibrosis was detected compared to subgroups (Ia&Ib) and (IIIa&IIIb) respectively.
Apoptosis and inflammatory cellular infiltration together with formation of fibrosis in autologous fat grafts resulted in significant decrease in number of normal sized adipocytes in subgroups (b) compared to subgroups (a) in all studied groups.
It was concluded that Both ASCs and ALA showed improvement in all histological parameters compared with control subgroup. However, enrichment of fat with ASCs showed the best results.