1. Insert Program or Hospital Logo Background Cleft palate is a congenital deformity that causes a multitude of problems. Speech production, feeding, maxillofacial growth and dentition are just a few important developmental areas that may be affected. Advances in cleft palate repair includes the use of autologous stem cells (SC). It is known that adult adipose tissue contains a notable concentration of SC, however this has not been published for pediatric adipose tissue. Autologous fat grafts have been effective in surgically repairing cleft palate as well as other facial deformities and scarring, but it is uncertain what quantity of SC are necessary for these procedures and thus what results can be expected. This study could lead to other similar studies using adipose-derived SC for repair of multitudes of congenital defects that typically require several surgeries to achieve normal function. Stem Cell Concentration In Pediatric Adipose Tissue (SCIPAT) Sheshashree Seshadri, MD (PGY-3), Shaye Walston, DO (PGY-3), Loretta Reyes, MD (PGY-3), Ifeanyi Mbadugha, MD, Kevin Hopkins, MD, FACS, Driscoll Children’s Hospital – Corpus Christi, TX Samir Hasan, MS III, Joan Nichols, MD, Joaquin Cortiella, MD, University of Texas Medical Branch – Galveston, TX Abstract The purpose of this study is to quantify the stem cell concentration present in adipose tissue in the pediatric population. The Objectives of this study are to: 1)Determine the average stem cell concentrations in adipose tissue of children and adolescents. 2)Determine the average differences in stem cell concentrations in pre-pubertal and post-pubertal ages. 3)Determine the average differences in stem cell concentrations in males versus females. 4)Determine the average differences in stem cell concentrations based upon Body Mass Index (BMI). We found that higher concentrations of stem cells were present in pre-pubertal children versus pubertal or post- pubertal children, and higher in healthy BMI versus children with BMI in the overweight or obese range. Description of study Study type: Non-therapeutic descriptive study Location: Driscoll Children’s Hospital- Plastic surgery Duration: 2 months and Ongoing Inclusion criteria: Patients with congenital /traumatic soft tissue and craniofacial defects such as cleft lip/cleft palate who undergo autologous adipose tissue injection to repair the defect (12 patients) Exclusion criteria: Participants with inadequate sample size of adipose tissue for fat analysis (0 patients) Fat analysis: Fat was aspirated from the abdomen and injected into the soft tissue defect. Residual fat was used for analysis. Fat analysis was performed in University of Texas Medical Branch - Galveston. A hemocytometer was used to count the SC and flowcytometry was used to stain the CD 105 + SC. Conclusions References The Effect of Age on Human Adipose-Derived Stem Cells - From Plastic and Reconstructive Surgery and Biomedical Engineering, Yale University School of Medicine -accepted July 20, 2012. Yield of human adipose-derived adult stem cells from liposuction Cryotherapy 2004;6(1):7-14 Artecel Sciences, Inc., Durham, NC, USA. Ducic, Y. “Fat grafting in trauma and reconstructive surgery.” Facial Plastic Surgery Clinics of North America 16.4 (November 2008): 409-416, v-vi. Kishi, K, et al. “Distribution of adipose-derived stem cells in adipose tissues from human cadavers.” Journal of Plastic, Reconstructive, and Aesthetic Surgery 63.10 (October 2010): 1717-1722. 2013 Texas Pediatric Society Electronic Poster Contest Figure 1: Distribution of data between pre-pubertal, pubertal, and post-pubertal ages shows a higher concentration in pre-pubertal children. Figure 2: Distribution of data between healthy BMI (5-85% ) and unhealthy BMI (>85%) shows a higher concentration in children with healthy BMI. Pre-Operative 17 Months Post-Operative Velopharyngeal Insufficiency 1)Based upon fat analysis results in pediatric adipose tissue, highest SC concentration is present in pre- pubertal patients with healthy BMI. 2)While these results are only a small sampling of a much larger population, further studies are warranted to determine if such factors can indeed affect SC concentrations. 3)From there, it can be determined if weight loss and/or younger age at time of autologous fat grafting can aid in improving cosmetic outcome in large population of patients. Results 1)When divided based on pre-pubertal, pubertal, and post-pubertal ages, those children who were pre- pubertal (6,145.9 cells/mL) were found to have higher stem cell concentrations than the other two groups (4,633.9 cells/mL and 1,394.2 cells/mL, respectively). 2)There was no significant difference between males (3,568 cells/mL) and females (3,823 cells/mL) in their stem cell concentration. 3)Children whose weight fell within the healthy BMI range (5-85%)(6,145.85 cells/mL), based upon CDC percentiles, were found to have higher stem cell concentrations than those children whose weight fell into the abnormal BMI range (> 85%, the ‘overweight’ or ‘obese’ categories)(910.7 cells/mL). P=0.0081 P= 0.04 Mann Whitney Test Analysis of the study Strengths of the Study 1)To our knowledge, this is the first pediatric study to measure the stem cell concentration in adipose tissue. 2)Our study provides questions for further research: -Whether weight loss and a decrease in BMI can lead to an increase in the stem cell concentration -Relationship between sex steroid hormones and stem cell concentration Limitations of the Study 3)Small sample size 4)Long term follow up still pending