Arthritis

01 June 2016

What is fat enriched stem cell therapy?

The process called fat enriched stem cell therapy involves stem cells retrieved from fat being used for tissue regeneration and the improvement of healing after surgery.

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When you mention stem cells, the first thing that generally comes to mind is embryonic stem cells and the fairly new trend of storing umbilical cords in case there is a need to for stem cell therapy in the future.

What isn’t generally known, however, is that it is possible to retrieve stem cells from fat – by way of liposuction – which can then be washed and cleaned and the stem cells are used for tissue regeneration and to improve healing after a surgery.

What are stem cells?

Stem cells are able to differentiate into specialised cell types. In other words, when a stem cell divides, the new cell could remain as a stem cell or it could become another type of cell that has a specialised function, such as a red blood cell or even a brain cell. Stem cell therapies fall under the term regenerative medicine, and is also referred to as cell based therapies. Stem cells are usually derived from two main sources: embryonic stem cells and adult stem cells.

Read: New hope from stem cells

What are fat enriched stem cells?

Adult stem cells are usually extracted from bone marrow (BMSC’s), which is an extremely painful process and only yields a small amount of usable stem cells. However, it is now known that fat tissue is an extremely rich source of adipose derived stem cells, or ADSCs. In fact, it was discovered that fat cells yields more ADSC’s than bone marrow and with more than 90% cell viability. In addition, the stem cells retrieved from fat cells are more easily cultured and grow more rapidly than those harvested from bone marrow.

What are the advantages of fat enriched stem cells?

The biggest advantage is that fat is readily available in almost all individuals and is easily obtained through a liposuction procedure. There is therefore no need to find a "donor" – the fat cells removed from a patient are used only for that specific patient. Fat is removed from the patient’s body through liposuction, half of which is used to extract stem and regenerative cells from the tissue, while the rest of the fat is washed to remove impurities and prepared for the transplant. The concentrated regenerative cells are mixed with the clean fat to form a fat-enriched graft – this method gives the stem cells a better chance of survival, and thus the regeneration and healing of the transplant is much faster.

Read: Organ transplant statistics

How is this process being used in South Africa?

While this procedure is commonly performed in Europe and Asia, it is not commonly performed in South Africa due to the high costs of equipment and consumables needed to perform the procedure.

Because plastic surgeons have been doing liposuction and fat grafting for many years, they are at the forefront of this technique. Professor Frank Graewe, plastic, reconstructive and micro-surgeon, says, “I have used this technique extensively in breast reconstruction, especially in patients with damaged tissue due to radiation. I have also used this procedure to promote healing and regeneration in wounds that have difficulty completely healing.”

Using fat enriched stem cells can also be used in cosmetic procedures to treat ageing hands or face as fat stem cells have been shown to increase elastic fibres in the skin. It can also be used to regenerate tissue in hip and knee joints to assist with osteoarthritis symptoms.

Read: Protect ageing skin

What the future holds

There are many other potential uses for this technique. Internationally there are clinics that have been formed that specialise in regenerative medicine using fat stem cells to treat orthopaedic conditions, neurological diseases, autoimmune diseases and even heart conditions.

“I have had patients from all over South Africa, investigating the option of using fat enriched stem cell therapy as a treatment option. So we are seeing the demand and we’re excited to be at the fore of these developments going forward,” concludes Graewe. It’s been proven that the use of fat is safe, efficient and cost effective for regenerative therapies and the application possibilities are endless.

Read more:

Stem cell, hard sell

Stem cell glossary

SA stem cell bank accredited

Who is Professor Graewe?

In 2014 Professor Frank Graewe was a member of the team that performed the world’s first successful penile transplant. He was responsible for all the microsurgery during the harvesting as well as the re-attachment. Prof Graewe is currently Head of the Plastic Surgery Division at Stellenbosch University as well as the Head of the Craniofacial Unit at Tygerberg Academic Hospital.    

 

Ask the Expert

Arthritis expert

Professor Asgar Ali Kalla completed his MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 1975 at the University of Cape Town and his FRCP in 2003 in London. Professor Ali Kalla is the Isaac Albow Chair of Rheumatology at the University of Cape Town and also the Head of Division of Rheumatology at Groote Schuur Hospital. He has participated in a number of clinical trials for rheumatology and is active in community outreach. Prof Ali Kalla is an expert in Arthritis for Health24.

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