The treatment phase begins with the collection of the biological material.

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The Science of Biological Repair

The Spectrum of Care: From Management to Cure

Regenerative medicine is more than just a simple injection. It is a sophisticated biological transfer that requires surgical precision, pharmaceutical-grade sterility, and advanced laboratory processing.

At Liv Hospital, we treat stem cell therapy as a Transplant Procedure. Whether we are harvesting cells from your own fat tissue or preparing high-dose Exosomes in our lab, every step is governed by strict GMP (Good Manufacturing Practice) protocols. We ensure that the cells remain viable, sterile, and potent from the moment they leave the donor source until they are delivered to the injured tissue.

We generally offer two categories of treatment:

  1. Same-Day Procedures (Point-of-Care): Harvesting, processing, and injecting in one single visit (e.g., SVF for knees).
  2. Two-Step Procedures (Culture Expansion): Harvesting on Day 1, growing cells in the lab for 2–3 weeks, and injecting on Day 21 (e.g., for Autoimmune disease or Anti-Aging).

This guide walks you through the journey from “Harvest to Healing.”

Step 1: Harvesting the Source

Conventional Supportive Therapy

The first step is obtaining the raw material. We use minimally invasive techniques to ensure patient comfort.

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Adipose (Fat) Tissue Harvesting

Hematopoietic Stem Cell Transplantation (HSCT)

Fat is the richest source of Mesenchymal Stem Cells (MSCs).

  • The Setting: An operating room or sterile procedure room.
  • Anesthesia: Local anesthesia (Tumescent) is injected into the belly or flank area. You are awake but feel no pain. We can offer light sedation (twilight sleep) if you are anxious.
  • The Procedure: The surgeon makes a tiny 2mm nick in the skin. A specialized cannula (thin tube) gently suctions out about 50–100cc of fat (about half a cup).
  • The Experience: It feels like a gentle tugging. It takes about 20 minutes. The incision is so small it often doesn’t need a stitch, just a sterile strip.
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Bone Marrow Aspiration

Gene Therapy: The Autologous Future
  • The Setting: Operating room.
  • Anesthesia: Local anesthesia to numb the skin and the periosteum (surface of the bone) on the back of the hip (iliac crest).
  • The Procedure: A specialized needle is inserted into the hip bone. We aspire about 60cc of marrow blood.
  • The Experience: You feel pressure when the needle enters, and a brief, sharp “ache” when the marrow is pulled out. The pain lasts only seconds.

Allogenic (Umbilical Cord)

  • No Harvest Needed: These cells are pre-processed from screened donors and stored in our cryo-bank (liquid nitrogen at -196°C).
  • The Prep: On the day of treatment, we thaw the vial under controlled conditions in the lab.

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Assoc. Prof. MD.  Handan Haydaroğlu Şahin Assoc. Prof. MD. Handan Haydaroğlu Şahin Stem Cell Overview and Definition
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Laboratory Processing

This is where Liv Hospital separates itself from standard clinics. We do not just spin the blood in a simple bedside centrifuge. We process it to isolate the “Gold.”

Isolation of SVF (Stromal Vascular Fraction)

For fat tissue, we must separate the useful stem cells from the oily fat cells.

  1. Washing: The fat is washed with saline to remove blood and oil.
  2. Enzymatic Digestion: We add a special enzyme (Collagenase) that dissolves the bonds holding fat cells together, freeing the stem cells.
  3. Centrifugation: The mixture is spun at high speed. The heavy stem cells sink to the bottom (the “pellet”), while the oil floats to the top.
  4. Filtration: We pass the cells through a microscopic filter to remove any clumps.
  5. Result: A concentrated liquid (5–10cc) containing millions of regenerative cells, ready for injection. Time: ~90 minutes.

Culture Expansion (The Multiplier)

For systemic diseases or anti-aging, we need hundreds of millions of cells.

  1. Seeding: We place the harvested cells into flasks with a nutrient-rich “growth medium.”
  2. Incubation: They are kept in a specialized incubator that mimics the human body (37°C, 5% CO2).
  3. Passaging: As the cells multiply and fill the flask, we move them to larger flasks.
  4. Harvest: After 2–3 weeks, we have 50–100 million pure MSCs.
  5. Testing: We perform sterility checks (bacteria/fungus) and Flow Cytometry (cell count) before releasing them for use.
Splenectomy

The Stem Cell Application

Injecting the cells blindly is a waste. We use guidance technology to ensure the cells land exactly where the damage is.

Intra-Articular Injection (Joints)

  • Ultrasound Guidance: We use a high-frequency ultrasound probe to visualize the needle in real-time. We watch the needle enter the joint space and release the cells. This guarantees we don’t hit the bone or inject into the surrounding fat.
  • The Feeling: A sensation of “fullness” or pressure in the joint as the fluid enters. It is generally not painful.

Intradermal Injection (Face/Scalp)

  • Numbing Cream: We apply a strong anesthetic cream for 30 minutes.
  • Napage Technique: The doctor uses a very fine needle (mesotherapy) to make hundreds of tiny, shallow injections across the face or scalp.
  • Microneedling: Sometimes we apply the stem cells topically and use a microneedling device to push them deep into the dermis.

Intravenous Infusion (Systemic)

  • The Setup: A standard IV line is placed in your arm.
  • The Drip: The stem cells are suspended in saline. They are infused slowly over 30–60 minutes.
  • Monitoring: We monitor your blood pressure and oxygen levels to ensure you don’t have an allergic reaction (which is extremely rare).
  • The Lung Trap: The cells first travel to the lungs, then redistribute to the rest of the body (homing to inflammation).

Specialized Combination Therapies

Often, stem cells work better with a “partner.”

PRP + Stem Cells (The “Fertilizer”)

  • The Concept: Stem cells are the “seeds.” Platelet Rich Plasma (PRP) is the “fertilizer.”
  • The Process: We draw a tube of your blood, spin it to concentrate the platelets (growth factors), and mix it with the stem cells before injection.
  • The Benefit: PRP provides an immediate burst of energy to help the stem cells survive and start working faster.

Exosome Therapy (The “Signal”)

  • The Product: A vial of concentrated Exosomes (purified from umbilical cord stem cells).
  • The Method: It can be injected locally (face/hair) or IV.
  • The Advantage: Because they are tiny nanoparticles (not whole cells), they can cross the Blood-Brain Barrier, making them potentially useful for neurological support.

Pain Management

We know the idea of “harvesting” sounds painful. We make it comfortable.

  • Pre-Medication: We offer an oral sedative (like Valium) to relax you before the procedure.
  • Tumescent Anesthesia: For liposuction, the fluid we inject contains Lidocaine (numbing) and Epinephrine (stops bleeding). You will be numb for hours after the procedure.
  • Cooling: For facial injections, we use cold air cooling devices (Zimmer) to numb the skin instantly during injection.

Safety and Sterility

In our GMP facility, safety is paramount.

  1. Double Witnessing: Two lab technicians verify your name and ID on every tube and flask to prevent sample mix-ups.
  2. Closed Systems: We use closed-circuit kits whenever possible, so the cells are never exposed to the open air of the room.
  3. Endotoxin Testing: We test the final product for bacterial toxins before it touches the patient.

What Happens After the Procedure?

  • Observation: You stay in our recovery lounge for 30–60 minutes.
  • Bandaging: For fat harvest, you will have a small waterproof dressing. You may need to wear a compression garment (like a tight belt) for a few days to prevent bruising.
  • Discharge: You can walk out of the hospital. You do not need crutches (for knee injections) or a wheelchair.

FREQUENTLY ASKED QUESTIONS

Can I drive home after the procedure?

If you had local anesthesia only, yes. If you chose oral sedation (Valium) or IV sedation, no. You must have a companion drive you or take a taxi to your hotel. Your reflexes will be slow.

  • SVF (Same Day): Total time is about 4–5 hours. (30 min harvest + 90 min lab processing + 30 min injection + observation).

Cultured Cells: Two visits. Visit 1 is 30 mins (harvest). Visit 2 (3 weeks later) is 60 mins (infusion).A typical same-day procedure, including harvesting, processing, and administration, generally takes between 3 and 5 hours.

The incision is tiny (2–3mm). It usually heals as a tiny dot that fades to skin color within 6 months. It is virtually invisible.

Yes. We often perform stem cell application during Arthroscopic Surgery. For example, the surgeon repairs a meniscus tear and then injects stem cells into the knee before closing up to accelerate healing.

Absolutely. Every needle, syringe, tubing, and processing kit is single-use and sterile. We never re-use equipment between patients.

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