The stromal – vascular fraction (SVF) is a unique cell complex derived from the patient’s own adipose tissue, separated from the stroma and adipocytes. SVF contains stromal cells of adipose tissue, endothelial and smooth muscle cells of blood vessels and their predecessors, pericytes, fibroblasts, blood cells, including B– and T lymphocytes. The regenerative potential of this fraction allows the use of cellular functionality in a wide range of nosologies.

At the moment, SVF is widely used in modern medical practice, as a minimally manipulated, highly effective cell product. This term is used to denote a product that can be obtained within a single surgical intervention “in situ”. In the process of preparing SVF, cells are not subjected to cultivation or other aggressive influences. According to the results of clinical studies, the presence of a large number of positive long-term results allows us to speak with confidence about the high potential of this fraction.

SVF contains:

Pericytes

The cells surrounding the blood capillaries and part of their walls, pericytes affect the proliferation of endotheliocytes

Pericytes

Adipose Stem Cells

Poorly differentiated (cambial) cells accompanying small blood vessels. These cells, through divergent differentiation, give rise to various cellular differentials (fibroblastic, myofibroblastic, adipocytic, etc.)

Adipose Stem Cells

Endothelial cells

Contribute to angiogenesis with the introduction of the graft

Endothelial cells

White blood cells

Cells that provide specific and non-specific protection. So SVF can be used during an active inflammatory response due to the presence of leukocytes in its composition

White blood cells

Red blood cells

Highly differentiated cells responsible for the transport of oxygen and carbon dioxide, amino acids, antibodies, toxins and a number of drugs, adsorbing them on the surface of the plasma membrane

Red blood cells

Smooth muscle cells of blood vessels

Cells that contribute to atherogenesis with the introduction of the graft

Smooth muscle cells of blood vessels

Endothelial Cell Precursors

Cells that contribute to the restoration of the endothelial layer and the maintenance of its normal function

Endothelial Cell Precursors

Advantages of SVF

Low invasiveness

The source of SVF is adipose tissue. For SVF isolation 50 to 200 ml of adipose tissue is required. The process of getting adipose tissue cells is liposuction, which is widespread in aesthetic medicine and is an absolutely routine procedure. The procedure is standardized, easy to perform and can be made under local anesthesia.

No cultivation

After isolation from adipose tissue, SVF is immediately administered to the same patient to repair damaged tissue or organ. Thus, there is no process of artificial cell cultivation. The patient is injected with his own cells, which have not undergone external processing.

Duration of isolation no more than 120 minutes using ESVIEF technology

The process of obtaining SVF using ESVIEF system is as standardized and simple as possible, which ensures the quality of the cells obtained, their necessary concentration, purity, sterility, as well as the speed and safety of the whole process.

The introduction of SVF into the patient’s tissue stimulates local synthesis of growth factors, cytokines, and extracellular matrix elements. This process stimulates neoangiogenesis, affects the modulation of the humoral response, ensures the maintenance of the viability of differentiated cells in the pathological focus. In addition, the introduction of SVF triggers the remodeling of pathologically altered tissues, leading to the induction of differentiation into specialized cells of mesenchymal origin.

Areas of application:

Endocrinology

Restoration of damaged ligaments and articular cartilage

Aesthetic medicine

Treatment of postoperative scars, scars, alopecia, pigmentation, scleroderma, as well as age-related

Regenerative surgery

Treatment of burns, trophic ulcers, autologous transplantation of SVF with neurotization of the muscular-cutaneous nerve

Gynecology

Treatment of recto-vaginal fistula

Plastic and reconstructive surgery

In the enrichment of lipoaspirate, for the correction of soft tissue defects, for example, dysplasia, post-traumatic and postoperative defects and for aesthetic purposes to improve the condition of the skin

Urology

Treatment of erectile dysfunction, urinary incontinence

Traumatology

Restoration of damaged ligaments and articular cartilage

Coloproctology

Treatment of fistulas in Crohn’s disease

Pulmonology

Treatment of idiopathic pulmonary fibrosis

Interventional cardiology

Restoration of the heart muscle in acute myocardial infarction, chronic heart failure

Orthopedics

Supplementation of SVF autologous plastics in post-traumatic recovery of peripheral nerves

Abdominal surgery

Treatment of fistulas in Crohn’s disease

Countries actively using SVF in medicine:

Ways to get SVF

To date, the market presents various methods for producing SVF, which can be divided according to the method of destruction of adipose tissue into enzymatic and non-enzymatic; as well as for application in the process of automated systems: manual, semi-automatic and automatic.

The enzymatic method consists in treating the lipoaspirate with an enzyme to destroy adipose tissue (for example, collagenase, trypsin, dispase, thermolysin). Although the methods for isolating cells from adipose tissue are quite diverse, they follow a specific procedure. The differences are mainly in the number of washing steps, enzyme concentration, centrifugation parameters, and filtration. The lipoaspirate is washed, treated with an enzyme, and then the cells are separated by centrifugation from mature adipocytes, oil and an enzyme solution. This method of obtaining SVF allows you to get a high concentration of viable cells of appropriate quality. The disadvantage of this method of producing SVF is the difficulty of standardizing the enzyme used, the activity and purity of which varies between series and manufacturers.

Enzymatic treatment of lipoaspirate can be carried out manually and automatically. The manual method requires expensive infrastructure and qualified specialists, which are not available in most clinics. In turn, the automatic closed system allows you to reduce risks regarding sterility and safety of the obtained fraction, allows you to standardize the process of isolation of SVF and does not require a laboratory that meets the standards for work with cells and human tissues (GTP). Automation of the process significantly reduces the cost of the procedure as a whole and allows biomaterial sampling, processing and product introduction within one operation.

A non-enzymatic method is based on the use of physical forces acting on a lipoaspirate: shear forces, centrifugal forces, radiation forces and pressure. These methods of producing SVF are characterized by a lower presence of red blood cells, free lipids, a larger percentage of mature cells compared to the enzymatic method, but they significantly lose in the quantitative result of the obtained cells.

Each method or system has its advantages and disadvantages and is in the stage of constant development and optimization.