Understanding and controlling the variables for stromal vascular fraction therapy

Table 1 Therapeutic regenerative products derived from adipose tissue

Regenerative product from adipose tissue	Description	Potential applications
Adipose-derived stem cells[16,17]	Multipotent stem cells capable of differentiating into multiple cell types	Tissue engineering, cell-based therapies
Stromal vascular fraction[18]	A heterogeneous cell population, including adipose-derived stem cells and other cell types	Wound healing, tissue repair, regenerative treatments
Extracellular vesicles[19]	Vesicles contain bioactive molecules like proteins and nucleic acids	Angiogenesis, immunomodulation, tissue healing
Adipokines[20]	Hormones and signaling molecules secreted by adipose tissue	Regulation of appetite, insulin sensitivity, inflammation, and lipid metabolism
ECM scaffolds[21]	Decellularized scaffolds maintain adipose tissue’s structural components	Tissue engineering, support for tissue regeneration
Microfat and nanofat[22]	Adipose tissue forms rich in regenerative cells and growth factors	Soft tissue augmentation, wound healing, tissue repair

ECM: Extracellular matrix.

Table 2 Comparative analysis of autologous vs allogenic stromal vascular fraction sources

SVF source	Advantages	Disadvantages
Autologous SVF	Eliminates immune rejection. No donor disease transmission. Enables personalized treatments	Requires surgical adipose extraction. Variable SVF quality and quantity
Allogenic SVF	Avoids surgery for each patient. Steady, ready supply. Beneficial for patients with scant adipose tissue	Possible immune response. Risk of disease if donor screening is lax

SVF: Stromal vascular fraction.

Table 3 Anesthesia options for stromal vascular fraction isolation procedures

Anesthesia type	Description	Application in SVF isolation
Local anesthesia[39]	Involves injecting anesthetic agents like lidocaine at the harvest site. Patients remain conscious and have minimal systemic side effects	Preferred for small-scale SVF isolation; ensures patient comfort and cooperation
Tumescent anesthesia[40]	Diluted lidocaine with epinephrine and saline is injected to anesthetize, minimize bleeding, and ease tissue harvest	Common in liposuction to obtain adipose tissue; provides extended anesthesia and vasoconstriction
General anesthesia[41-43]	Induces complete sedation and unconsciousness, used in comprehensive surgical settings	Rarely used solely for SVF isolation; considered if combined with other surgical interventions

SVF: Stromal vascular fraction.

Table 4 Common sites for stromal vascular fraction aspiration from subcutaneous adipose tissue

Common SVF aspiration sites	Description
Abdomen[44]	Preferred due to accessibility and ample subcutaneous fat; less invasive for adequate tissue collection
Thighs[44]	Inner and outer thighs provide a high concentration of subcutaneous fat suitable for harvesting
Flanks[44]	Often chosen for excess adipose tissue, easily accessible for SVF aspiration
Buttocks[44]	Utilized when a significant amount of adipose tissue is needed, especially in regenerative procedures

SVF: Stromal vascular fraction.

Table 5 Comparative analysis of adipose tissue harvesting tools: Hypodermic needle vs liposuction cannula

Instrument	Advantages	Disadvantages
Hypodermic needle	Widely available and cost-effective. Simple, easy for manual aspiration. Various sizes for different applications	Limited use for large-scale harvesting. Multiple punctures may be necessary
Liposuction cannula	Efficient for large-volume harvesting. Suitable for extensive liposuction needs. Reduces trauma to surrounding tissues	Requires special equipment and training. Less suitable for small-scale procedures

Table 6 Instrument selection criteria: Hypodermic needle vs liposuction cannula

Factor	Hypodermic needle	Liposuction cannula
Adipose tissue amount required	Suitable for smaller quantities	Preferred for larger volumes
Procedure type	Ideal for manual aspiration	Designed for liposuction procedures
Patient comfort	Potentially less invasive and more comfortable	Larger cannulas may be more discomforting
Physician expertise	Requires basic proficiency in aspiration techniques	Necessitates expertise in liposuction equipment and methods
Safety	Low-risk tool for manual procedures	Must be used in line with stringent safety protocols

Table 7 Centrifugation speed and time parameters for stromal vascular fraction isolation

Centrifugation parameters	Speed, × g	Time in min
Low-speed centrifugation	400-600	5-10
Medium-speed centrifugation	1200-1500	10-15
High-speed centrifugation	2000-2500	15-20

Table 8 Perspectives on stromal vascular fraction isolation in regenerative medicine

Perspective	Description
Regenerative potential	Highlights the diverse cells in SVF, like adipose derived stem cells, for tissue repair and potential in regenerative medicine
Non-invasive approach	Stresses minimally invasive adipose tissue harvest, leading to less discomfort and quicker recovery
Ethical and safety considerations	Notes the ethical advantage of autologous use and lower risk of rejection or disease transmission
Clinical applications	Discusses the role of SVF in osteoarthritis, wound healing, and other regenerative areas
Standardization and quality control	Urges for standardized protocols to ensure consistent results and safety in SVF therapies
Evolving research	Emphasizes the need for ongoing research to expand understanding and clinical use of SVF

SVF: Stromal vascular fraction.