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Investigating the Influence of Tranexamic Acid on Adipocyte Differentiation in an In Vitro Model
Giorgianna Ellis
*1, Tiffany DeSouza
2, Jahnavi Challagonda
1, Alex Joo
1, Anam J. Furrukh
1, Sneha Palmieri
1, Silvia Corvera
2, Janice F. Lalikos
11Plastic Surgery, UMass Chan, Weston, MA; 2Program in Molecular Medicine, University of Massachusetts Chan Medical School, Worcester, MA
Background: Tranexamic acid (TXA) has gained traction in plastic surgery for its ability to improve procedural outcomes by mitigating blood loss, hematoma formation, swelling, and bruising. One notable application is its use in tumescent solution for liposuction and fat grafting. This study investigates whether TXA compromises adipocyte differentiation and the capacity of resulting cells to acquire normal structure and function, with implications for fat graft retention.
Methods: Adipose tissue explants from human subcutaneous fat were cultured in a 3D system with TXA concentrations (vehicle, 100 µg/mL, 1000 µg/mL). Capillary sprouting was recorded from day 4 to 12. After 14 days, human Adipose Capillary Associated Progenitor Cells (hACAPs) were isolated and maintained in 2D cultures with the same TXA concentrations. Growth rate was assessed through two expansions. Cells then underwent adipogenic differentiation for 10 days using MDI; a subset of these cells were subsequently treated with forskolin, a thermogenic agonist. Adipogenic differentiation was assessed via RT-qPCR and lipid droplet imaging.
Results: Capillary sprouting, cell yields, and growth rates were equivalent across all groups. Cell morphology and lipid droplet accumulation were unchanged after MDI treatment. Expression of adipogenic genes AdipoQ, PLIN1, and FABP4 was similar after 10 days of differentiation. Following thermogenic activation via forskolin, expression of UCP1, LINC00173, and DIO2 was also similar.
Conclusion: TXA did not compromise adipogenic differentiation or thermogenic responsiveness in hACAPs in vitro. Higher TXA concentrations transiently attenuated early capillary sprouting, though this effect resolved by day 5-6 and overall sprouting was equivalent across all groups. These findings support the safety of TXA in tumescent solution with respect to adipocyte biology. Future work should evaluate adipocyte biology in the context of other commonly used tumescent adjuncts to fully characterize their combined impact on graft outcomes.
Models adjusted for BMI, tissue expander size, and axillary irradiation. OR > 1 indicates higher odds with early exchange.
Back to 2026 Abstracts
Models adjusted for BMI, tissue expander size, and axillary irradiation. OR > 1 indicates higher odds with early exchange.
