Joris van Dongen

42 Chapter 2 Table 5A. Cell yield and viability per milliliter start volume of lipoaspirate of all intraoperative isolation procedures per study. Enzymatic isolation procedure Cell yield x10 5 cells/ml SD Viability nucleated cells (%) SD AIS (SundarRaj, 2015) 1,2 0,5 98% 21 CHA (Aronowitz, 2013) 0,6 0,15 87% 12 CYT (Aronowitz, 2013) 2,4* 0,32 93% 2 CYT (Aronowitz, 2016) a 1 0,16 84%* 1 CYT (Domenis, 2015) 11,7 0,5 CYT (Lin, 2008) 3,7 0,86 89% 1 GID SVF2 (Aronowitz, 2016) a 2,9 0,65 69% 6 LIPOK (Domenis, 2015) 5 3 LIPOK (Aronowitz, 2013) 0,3 0,15 72% 15 LIPOK (Aronowitz, 2016) a 6,2* 0,25 50% 10 PNC (Aronowitz, 2013) 1,1 0,49 57% 21 PNC (Aronowitz, 2016) a 5,4* 1,64 82%* 5 SEPAX (Güven, 2012) 2,6* 1,2 TGCIS (Doi, 2012) 7 1,89 81% *Significantly best procedure tested in their study (p>0.05); a No exact data mentioned in text, data extracted from figures by authors JAD and AJT. AIS Automated Isolation System; CHA-station (CHA-Biotech); CYT Celution System Enzymatic (Cytori); GID SVF2 (GID Europe); LIPOK Lipokit System (Medi-khan); PNC Multi station (PNC); SEPAX Sepax (Biosafe); TGCIS Tissue Genesis Cell Isolation System (Tissue Genesis) More interesting than comparing intraoperative isolation procedures evaluated in different studies might be the comparison between an intraoperative isolation procedure and a non-intraoperative isolation protocol (gold standard) starting from the same lipoaspirate. Six studies reported the results of such comparisons (Table 6A) 69,73-77 . The Automated isolation system and Tissue genesis cell isolation system resulted in the same cell yield as the non-intraoperative isolation protocol control (effect size, respectively, 0.07 and 0.00) 69,76 . Sepax isolated a higher cell yield compared to a non- intraoperative isolation protocol (effect size 1.11) (Table 6A) 75 . Lower cell yield was seen after using the Lipokit system compared to the non-intraoperative isolation protocol control (effect size -0.52) 74 . Interestingly, the highest positive as well as the most negative effect sizes were seen with the enzymatic Celution system related to regular isolation with a non-intraoperative isolation protocol 73,74 .