Adipose Tissue-Derived Stromal Vascular Fraction

Stromal vascular fraction (SVF) is an autologous biologic that has been used in treating musculoskeletal pathologies in animals and humans for two decades. SVF often is obtained by enzymatic digestion and has been used to treat osteoarthritic joints, tendinopathies, chronic wounds, scars, and in the areas of reconstructive surgery following mastectomy and other cosmetic dermatology conditions. Both manual and instrumented approaches are used in producing SVF for point of care treatments. The cellularity of SVF is an active area of investigation, which started with the discovery of the presence of adipose-derived mesenchymal stromal cells (AD-MSCs) in human adipose tissue. Higher numbers of SVF cells used to treat knee OA were shown to improve outcomes, but additional characterization of progenitor cells, including AD-MSCs, in SVF is needed. Investigating the contribution of AD-MSC derived exosomes in attaining beneficial therapeutic outcomes could result in refining the use of SVF as a therapy. Establishing best practices for the use of autologous SVF will require the adoption of automated methods of production, and the performance of higher-level clinical studies with larger numbers of study participants. Efforts at commercialization of SVF therapy are underway, which will make this promising therapy more widely available in the future.