RECELL Clinical Education (Warning: Graphic Medical Images), page-35

CHICAGO — An autologous skin cell suspension device allows for faster, more accessible and efficacious melanocyte-keratinocyte transplant procedures for vitiligo, according to a presentation here.

“For those of us that are really passionate about vitiligo, we are so excited to see the advancements in treatments both on the medical and procedural side that are coming out,” Nada Elbuluk, MD, MSc, associate professor of dermatology at University of Southern California and director of the skin of color and pigmentary disorders program at Keck School of Medicine, said during a presentation at the American Society for Dermatologic Surgery Annual Meeting.

Melanocyte-keratinocyte transplant procedures (MKTP) are not commonly done in the United States due to the need for specialized equipment and staff; however, the newly FDA-approved RECELLautologous skin cell suspension device (ASCS, Avita) could help change that, according to Elbuluk.

Nada Elbuluk

The device is disposable and includes an incubation well, rinsing well and strainer and the MKTP process can be completed within 30 minutes.

“The data so far from the device show that from about a 4 cm donor site, you get about 500,000 viable melanocytes,” Elbuluk said. “What’s also important that we’re learning with repigmentation with vitiligo, it’s not just the melanocytes that matter. The reason it’s called MKTP is you want to transplant the keratinocytes, too, and there’s new data emerging that having fibroblasts there may also be further helpful in aiding the repigmentation.”

A randomized controlled trial used the RECELL device to conduct MKTP in sites of at least 16 cm in 25 patients. The sites were divided in half with one section receiving MKTP followed by narrowband UVB and the other half receiving only narrowband UVB. A small zone in the middle was left with no treatment.

The study looked at donor-to-recipient site ratios of 1:5, 1:10 and 1:20 and found that 1:20 showed exceptional efficacy.

“With our punch grafting or suction blister grafting it’s 1:1 essentially. ... So this is really exciting. It means you can take a small donor site and really be able to treat a much larger recipient site,” Elbuluk said.

Six months after treatment 56% of patients achieved at least a 50% improvement in vitiligo and 36% achieved at least an 80% improvement, with 100% durability being recorded at 1 year.