Rigotti G, Marchi A, Galiè M, Baroni G, Benati D, Krampera M, Pasini A, Sbarbati A, et al.
Plastic and reconstructive surgery. Date of publication 2007 Apr 15;volume 119(5):1409-22; discussion 1423-4.
1. Plast Reconstr Surg. 2007 Apr 15;119(5):1409-22; discussion 1423-4.
Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: a
healing process mediated by adipose-derived adult stem cells.
Rigotti G(1), Marchi A, Galiè M, Baroni G, Benati D, Krampera M, Pasini A,
Sbarbati A.
Author information:
(1)Second Division of Plastic and Reconstructive Surgery, the Institute for
Burns, and Regional Center for Breast Reconstruction, Ospedale Maggiore di
Verona, Verona, Italy. gino.rigotti@azosp.vr.it
Comment in
Plast Reconstr Surg. 2008 Aug;122(2):680; author reply 680-1.
BACKGROUND: There is evidence that stem cells contribute to the restoration of
tissue vascularization and organ function. The objective of this study was to
assess the presence of adipose-derived adult stem cells left in their natural
scaffold in the purified lipoaspirate and to assess the clinical effectiveness of
lipoaspirate transplantation in the treatment of radiation side effects.
METHODS: This study was designed beginning with surgical procedures in 2002 and
envisaging a continuous patient follow-up to 31 months. Twenty consecutive
patients undergoing therapy for side effects of radiation treatment with severe
symptoms or irreversible function damage (LENT-SOMA scale grade 3 and 4) were
enrolled. Purified autologous lipoaspirates (60 to 120 cc) taken from a healthy
donor site were administered by repeated low-invasive computer-assisted
injection. Therapy outcomes were assessed by symptoms classification according to
the LENT-SOMA scale, cytofluorimetric characterization, and ultrastructural
evaluation of targeted tissue.
RESULTS: In the isolated stromal vascular fraction of 2 cc of human lipoaspirate,
cells with mesenchymal stem cell physical properties and immunophenotype were in
average 1.07 +/- 0.5 percent (n = 4), with a clonogenic fraction of 0.139
percent. At least 1.02 x 10(3) colony-forming units-fibroblast were present in
each lipoaspirate. Ultrastructure of target tissue systematically exhibited
progressive regeneration, including neovessel formation and improved hydration.
Clinical outcomes led to a systematic improvement or remission of symptoms in all
evaluated patients, including otherwise untreatable patients exhibiting initial
irreversible functional damage.
CONCLUSIONS: This surgical procedure is a low-invasive therapeutic approach for
resolving the late side effects of radiotherapy. According to the proposed
hypothesis of the ischemic nature of radiolesions, treatment with lipoaspirate
transplantation is potentially extended to other forms of microangiopathies.
DOI: 10.1097/01.prs.0000256047.47909.71
PMID: 17415234 [Indexed for MEDLINE]
