Joris van Dongen

51 Comparison of SVF isolation procedures: a systematic review Table 9. Disclosures of included studies. Articles Disclosures Aronowitz et al. 2013 Loan devices CHA and Cytori Aronowitz et al. 2016 No disclosures Bianchi et al. 2013 Lipogems Doi et al. 2012 Kaneca, Inc Domenis et al. 2015 No disclosures van Dongen et al. 2016 No disclosures Güven et al. 2012 Biosafe SA and loan Sepax Lin et al. 2008 Cytori Therapeutic Inc Mashiko et al. 2016 No disclosures Millan et al. 2014 No disclosures Osinga et al. 2015 No disclosures SundarRaj et al. 2015 No disclosures Tonnard et al. 2013 No disclosures DISCUSSION Grafting of lipoaspirates and of SVF in particular, is a rapidly evolving treatment modality for scars and other skin defects, arthritis, neuropathy, diabetic ulcers to mention a few. Many of these, initially small scale, single center studies, are on the verge of expansion to multicenter placebo-controlled double-blind randomized clinical trials. An important prerequisite is the use of an efficient and standardized intraoperative isolation procedure of SVF. This systematic review shows that none of these procedures supersedes other procedures in terms of cell yield, viability and SVF composition while being time and cost efficient too when analyzed using the same lipoaspirate. However, three intraoperative isolation procedures (shuffling 5 times, shuffling 30 times and Lipogems) showed only a minimal reduction of the volume of lipoaspirate, implicating that most of the adipocytes still are intact. Consequently, these three procedures are methods of processing rather than isolation procedures 22,71 . Moreover, there is a wide variation in cell yield, viability of cells and composition of SVF when all intraoperative isolation procedures are compared together. Study characteristics showed small and varied sample sizes regarding the number, sex and age of the donors. It is known that the cell yield and viability of SVF differ among donors, depending on age, harvest location and co-morbidities, such as obesity, of the donors 18-21,79 . This interdonor variability is a possible explanation for the variations