Not Stromal Vascular Fraction (SVF) or Nanofat, but Total Stromal-Cells (TOST): A New Definition. Systemic Review of Mec
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Online ISSN 2212-5469
REVIEW ARTICLE
Not Stromal Vascular Fraction (SVF) or Nanofat, but Total Stromal-Cells (TOST): A New Definition. Systemic Review of Mechanical Stromal-Cell Extraction Techniques H. Eray Copcu1
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Sule Oztan1
Received: 5 September 2020 / Revised: 4 October 2020 / Accepted: 19 October 2020 Ó The Korean Tissue Engineering and Regenerative Medicine Society 2020
Abstract The most important and greatest source in the body for regenerative cells is fat tissue. Obtaining regenerative cells from adipose tissue can be done in two ways: Enzymatic and mechanical. The regenerative cell cocktail obtained by the enzymatic method, including stem cells, is called Stromal vascular fracture (SVF). In the literature, there is no clear definition of regenerative cells obtained by mechanical method. We systematically searched the techniques and definitions for stromal cells obtained from adipose tissue by scanning different databases. To evaluate the mechanical stromal-cell isolation techniques and end products from adipose tissue. Systematic review of English and non-English articles using Embase, PubMed, Web of Science and Google scholar databases. Search terms included Nanofat, fragmented fat, mechanical stromal / stem cell, mechanical SVF, SVF gel. We screened all peer-reviewed articles related with mechanical stromal-cell isolation. Author performed a literature query with the aforementioned key words and databases. A total of 276 publications containing the keywords we searched were reached. In these publications, there are 46 different definitions used to obtain mechanical stromal cells. The term SVF is only suitable for enzymatic methods. A different definition is required for mechanical. The most used term nanofat is also not suitable because the product is not in both ‘‘fat’’ and in ‘‘nanoscale’’. We think that the term total stromal-cells would be the most appropriate definition since both extracellular matrix and all stromal cells are protected in mechanical methods. Keywords SVF Nanofat Stromal cells Regeneration Mechanical isolation Total stromal cells
1 Introduction Regenerative medicine is the most popular subject of recent years in aesthetic plastic surgery and regenerative medicine. There are a growing number of sources in literature regarding regenerative cells, stem/stromal cell applications for different indications in several disciplines. Although cell therapies are very important and promising a valuable future, De Francesco, one of the most important & H. Eray Copcu [email protected] Sule Oztan [email protected] 1
Plastic and Reconstructive Surgery, MEST Medical Services, Cumhuriyet Bulv. No:161/A,1,2 Alsancak, Izmir, Turkey
authors on this subject, explains the reasons why it still cannot find the place it deserves: restrictive worldwide measures, which fundamentally entail a common operating protocol, toxin- and xeno-free reagents, replacing enzymes and enabling a rapid monitoring of quality standards to ensure an adequate cell identity and the efficiency of the donor tissue [1
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