Joris van Dongen

26 Chapter 2 ABSTRACT Introduction Intraoperative application of stromal vascular fraction (SVF) of adipose tissue, requires a fast and efficient isolation procedure of adipose tissue. This review was performed to systematically assess and compare procedures currently used for the intraoperative isolation of cellular SVF (cSVF) and tissue SVF (tSVF) which still contains the extracellular matrix. Methods Pubmed, EMBASE and The Cochrane Central Register of controlled trials databases were searched for studies that compare procedures for intraoperative isolation of SVF (searched 28 th of September, 2016). Outcomes of interest were cell yield, viability of cells, composition of SVF, duration, cost and procedure characteristics. Procedures were subdivided in procedures resulting in a cSVF or tSVF. Results Thirteen out of 3038 studieswere included, evaluating eighteen intraoperative isolation procedures,were considered eligible. In general, cSVF and tSVF intraoperative isolation procedures had comparable cell yield, cell viability and SVF composition compared to a non-intraoperative ( i.e. culture lab-based collagenase protocol) control group within the same studies. The majority of intraoperative isolation procedures are less time consuming than non-intraoperative control groups, however. Conclusion Intraoperative isolation procedures are less time-consuming than non-intraoperative control group with similar cell yield, viability of cells and composition of SVF and therefore more suitable for use in the clinic. Nevertheless, none of the intraoperative isolation procedures could be designated as preferred procedure to isolate SVF.