Deferoxamine Preconditioning of Irradiated Tissue Improves Perfusion and Fat Graft Retention

Background: Radiation therapy is a mainstay in the treatment of many malignancies, but collateral damage to surrounding tissue, with resultant hypovascularity, fibrosis, and atrophy, can be difficult to reconstruct. Fat grafting has been shown to improve the quality of irradiated skin, but volume retention of the graft is significantly decreased. Deferoxamine (DFO) is a FDA-approved iron-chelating medication for acute iron intoxication and chronic iron overload that has also been shown to increase angiogenesis. The present study evaluates the effects of DFO treatment on irradiated skin and subsequent fat graft volume retention. Methods: Mice underwent irradiation to the scalp followed by treatment with deferoxamine or saline and perfusion and were analyzed using laser Doppler analysis (LDA). Human fat grafts were then placed beneath the scalp and retention was also followed up to eight weeks radiographically. Finally, histologic evaluation of overlying skin was performed to evaluate effects of deferoxamine preconditioning. Results: Treatment with DFO resulted in significantly increased perfusion, as demonstrated by LDA and CD31 immunofluorescent staining (*p 0.05). Importantly, fat graft volume retention was significantly increased when the irradiated recipient site was preconditioned with DFO (*p