Figure 1.

The steps of adipose stem cell therapy. Two modes of human adipose stem cell (hASC) therapy are highlighted, and examples of some critical issues at each step are shown (but by no means are all inclusive). In mode 1 of hASC therapy, standardized methods should be developed to prescreen each patient for hASC therapy candidacy and to determine the best method of adipose tissue acquisition (whether resection, liposuction, or an alternative). Because Current Good Manufacturing Practice facilities for hASCs could be located off-site, technologies for shipping hASCs should be optimized. Cell isolation technologies should maximize cellular yield. There will be many issues to consider when manipulating cells, including the high level of hASC variability between donors and the inherently heterogeneous cell population. The development of closed-system devices that continually monitor cells and adjust culture conditions to deliver a consistent hASC output might be especially useful in achieving this goal. In addition, if the patient would prefer to bank cells for future procedures, long-term storage methods must be validated for safety and efficacy. An ideal mode of hASC administration would be both condition-specific and patient-specific. After hASC treatment, standard methods are needed to monitor a patient for adverse side effects. In mode 2, hASCs are isolated, processed, and administered back to the patient at the point of care. This method will require the optimization of closed-system isolation devices and the determination of whether the stromal vascular fraction or hASCs will be the final cell therapy delivered back to the patient.