Host immune determinants of stromal vascular fraction graft survival: Toward a concept of SVF therapy resistance - A systematic narrative review.

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Stromal vascular fraction (SVF)-based therapies and autologous fat grafting have emerged as promising regenerative strategies due to their pro-angiogenic, immunomodulatory, and trophic properties. However, despite encouraging preclinical and clinical findings, therapeutic outcomes remain highly heterogeneous, with marked variability in graft retention and functional efficacy between patients. Increasing evidence suggests that this variability cannot be explained solely by procedural factors or cellular composition, but may also depend on host-related immune and microenvironmental determinants. This review explores the biological mechanisms governing SVF engraftment and introduces the emerging concept of "SVF therapy resistance," defined as the failure of autologous regenerative therapies resulting from maladaptive interactions between transplanted stromal cells and the host tissue environment. Particular attention is given to sterile inflammation, innate immune activation, and early graft-host interactions. Following transplantation, tissue injury and ischemia induce the release of danger-associated molecular patterns (DAMPs), triggering neutrophil recruitment, macrophage activation, complement signaling, and inflammatory remodeling. While controlled inflammatory responses may support tissue repair and angiogenesis, excessive neutrophil activation, neutrophil extracellular trap

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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