What Happens During Cell Culture in Adipose Stem Cell Therapy?

Hello, I am Dr. Hidenori Shimada of Grand Green Osaka Umekita Clinic in Osaka, Japan.

If you are considering adipose-derived stem cell therapy in Japan, you may notice that the treatment does not happen in a single visit. Between the fat collection and the infusion, there is a stage that patients rarely see: the cells are cultured and expanded at a specialized facility. This article explains, in general terms, what that culture step is, why it is part of the process, and which questions are worth bringing to a physician at Grand Green Osaka Umekita Clinic in Osaka.

The Short Answer: Culture Turns a Small Sample Into a Usable Amount of Cells

In this treatment, a very small amount of your own fat tissue is collected under local anesthesia. According to the clinic’s treatment information, only a few rice-grain-sized pieces of fat are needed. That sample contains mesenchymal stem cells, but not in a quantity intended for infusion. The sample is therefore sent to a specialized facility, where the mesenchymal stem cells are cultured and expanded before being returned to your body by IV infusion.

Culture is simply the process of helping cells grow under controlled laboratory conditions. Because the cells come from you (an autologous approach), the process is built around your own sample from start to finish. This is a self-pay treatment, not covered by Japanese health insurance, and whether it is suitable for you can only be decided by a doctor after a consultation.

Why Is a Culture Step Needed at All?

Mesenchymal stem cells are somatic stem cells found in fat tissue, bone marrow, and other tissues. They have been reported to differentiate into fat, bone, and cartilage cells, and to secrete anti-inflammatory substances and growth factors that support the repair of damaged tissue. Research and clinical applications are advancing worldwide, although the evidence differs from condition to condition and is still developing.

Fat tissue is considered to contain more mesenchymal stem cells than bone marrow, which is one reason it is used as a source. Even so, a small collection does not yield the number of cells intended for infusion. Culture and expansion bridge that gap. For patients, the practical meaning is that treatment is a multi-step journey with a waiting period, not an on-the-spot procedure.

What Does the Treatment Journey Look Like Around the Culture Step?

The exact schedule is confirmed by your physician, but the overall sequence can be understood as follows.

• A consultation, where a doctor reviews your medical history, current treatments, and goals.
• A fat collection visit, performed on an outpatient basis under local anesthesia.
• Culture and expansion of your mesenchymal stem cells at a specialized facility.
• An infusion visit, in which the cultured cells are given by IV drip, also on an outpatient basis.

Because there is a gap between collection and infusion, international patients in particular should ask how many visits are expected, how the timing between them is arranged, and what happens if travel plans or health conditions change. These are questions for the clinic, and answers can vary from person to person.

How Does Japan’s Regulatory Framework Relate to Cell Culture?

In Japan, treatments that use cultured cells are provided under the Act on the Safety of Regenerative Medicine, which requires a regenerative medicine provision plan to be submitted and reviewed. Cell culture and processing are part of what such a plan describes. The framework is designed to set expectations for how cells are handled, but it does not mean that any outcome is assured, and it does not replace your own discussion with a doctor.

If you want to understand how a clinic works under this system, you can ask which provision plan covers the treatment, where cell processing takes place, and how your sample is identified and tracked during culture. A clear, patient-friendly explanation is a reasonable thing to expect.

Questions to Ask Before You Decide

Before agreeing to any regenerative treatment, it helps to prepare a short list of questions. The culture step raises several that are easy to overlook.

• What condition or concern is the treatment being considered for, and what is the evidence behind it?
• What are the possible risks and side effects, including those related to fat collection and infusion?
• What are the fees, how many sessions are planned, and which items are included in the quoted cost?
• How will the treatment fit alongside your current medical care? Standard treatments should not be stopped or replaced without your doctor’s advice.
• What happens if the cultured cells cannot be prepared as planned?

None of these questions is a sign of distrust. They are the kind of information a physician should be willing to explain, and a careful consultation makes it easier to decide whether to proceed or to choose another option.

Planning Your Consultation in Osaka

Grand Green Osaka Umekita Clinic is located in Umeda, Osaka, and offers information pages for international patients, so you can review the basics of adipose-derived stem cell therapy in advance. Please consult the clinic’s treatment page and fee page for current details on costs, the number of sessions, the treatment period, risks, and side effects, and bring any medical records you have to your first appointment.

In summary, the culture step is the reason adipose-derived stem cell therapy is a staged process rather than a single procedure. Understanding it ahead of time can help you ask better questions, plan travel more realistically, and have a more informed conversation with your doctor. This article is general information and not a substitute for a medical consultation.

1. 1ConsultationDoctor reviews your history
2. 2Fat collectionOutpatient, local anesthesia
3. 3Cell cultureAt a specialized facility
4. 4IV infusionOutpatient visit

This figure is a conceptual diagram that summarizes the article

References

• PubMed: Clinical Efficacy and Safety of the Intra-articular Injection of Autologous Adipose-Derived Mesenchymal Stem Cells for Knee Osteoarthritis: A Phase III, Randomized, Double-Blind, Placebo-Controlled Trial. (2023)
• PubMed: Isolation, cultivation, and characterization of human mesenchymal stem cells. (2018)
• PubMed: Mesenchymal stromal/stem cell tissue source and in vitro expansion impact extracellular vesicle protein and miRNA compositions as well as angiogenic and immunomodulatory capacities. (2024)
• PubMed: Biomimetic Culture Strategies for the Clinical Expansion of Mesenchymal Stromal Cells. (2023)
• PubMed: Influences of Xeno-Free Media on Mesenchymal Stem Cell Expansion for Clinical Application. (2021)
• PMC: Re-using blood products as an alternative supplement in the optimisation of clinical-grade adipose-derived mesenchymal stem cell culture. (2017)
• PMC: Autologous platelet-rich plasma: a biological supplement to enhance adipose-derived mesenchymal stem cell expansion. (2015)
• PMC: Adipose derived mesenchymal stem cell therapy in the treatment of isolated knee chondral lesions: design of a randomised controlled pilot study comparing arthroscopic microfracture versus arthroscopic microfracture combined with postoperative mesenchymal stem cell injections. (2015)
• MHLW (Japan): Regenerative Medicine — Ministry of Health, Labour and Welfare, Japan

Supervising Physician

Director, Medical Corporation Shimada Clinic
Head of Clinical Practice, Grand Green Osaka Umekita Clinic

Hidenori Shimada

Graduated from the University of Tokushima Faculty of Medicine in 2005. After his initial residency, he obtained U.S. medical certification (ECFMG) and trained as a sub-intern in general surgery at the University of Washington. After completing the doctoral program at Kyoto University Graduate School of Medicine and working as a researcher at the Center for iPS Cell Research and Application (CiRA), Kyoto University, he founded Shimada Clinic in 2013. At Grand Green Osaka Umekita Clinic (https://umekitaclinic.org), he is engaged in a wide range of care, from internal medicine and pediatrics to cell therapy and aesthetic medicine.

* The physician supervision of this article covers its academic content only and does not constitute a recommendation of any specific treatment or product.