The effect of deferoxamine on fat graft survival in tamoxifen use: An experimental study

Introduction: Autologous fat graft survival depends on many variables such as vascularization and inflammation. Fat grafts are also frequently used in breast reconstructions. Objective: The objective is to investigate the effect of tamoxifen (TAM), which is frequently used in hormonal therapy after breast cancer, on fat graft survival and to determine the possible benefits of local and systemic deferoxamine (DFO) applications with TAM. Materials and Methods: Thirty-two female Wistar Albino rats were randomly divided into four groups. Fat graft from the inguinal region was transferred to the left subscapular area, suprafascial plan on the back of the rats. No application was made to the control group after fat grafting. Group 2 received TAM by oral gavage, Group 3 received TAM + local (L) DFO application to the fat graft area, and Group 4 received TAM + intraperitoneal (IP) DFO application. The grafted adipose tissue was excised 2 months after surgery. Macroscopic and histopathologic analysis was performed. Results: In the 2nd postoperative month, the weight and volume of fat grafts were significantly higher in the TAM + L DFO and TAM + IP DFO groups compared to the control group, whereas there was no statistically significant difference in the TAM-only group. Furthermore, vascularization and vascular endothelial growth factor (VEGF) expression were significantly increased in the TAM + L DFO and TAM + IP DFO groups compared to the control and TAM groups. Conclusions: Local DFO application to the fat graft recipient site and systemic DFO application increased fat graft survival in TAM-treated rats. VEGF expression was shown to increase with DFO and fat graft survival was also increased accordingly. The use of DFO is promising in improving fat graft survival in breast reconstruction patients using TAM.