Non-Enzymatic Isolation of Stromal Vascular Fraction (SVF) And Adipose-Derived Stem Cells (ADSCs): A Systematic Methodological Review and Meta Analysis

Non-enzymatic isolation of the stromal vascular fraction (SVF) has gained increasing clinical interest due to the regulatory, safety, and logistical constraints associated with enzymatic digestion. However, reported outcomes following their use remain heterogeneous, and direct quantitative comparisons are limited. This systematic review and exploratory meta-analysis aimed to compare SVF yield and in vitro proliferation outcomes across different non-enzymatic isolation techniques. A PRISMA-guided search of PubMed, Scopus, ScienceDirect, Google Scholar, and the Cochrane Library identified 17 eligible studies published up to May 2023. Device-based systems were the most frequently reported (35.3%), followed by wash-based methods (15%), kits (15%), centrifugation (12%), and other mechanical approaches. The pooled mean SVF yield was comparable between wash-based (0.33 × 10⁶ cells/g) and shear force–based techniques (0.34 × 10⁶ cells/g). The proliferative capacity varied across methods, with some mechanical and kit-based systems reaching confluence earlier than wash-based approaches. Substantial heterogeneity was observed across the included studies. These findings present clinically feasible alternatives for SVF recovery, demonstrating comparable mean cell yields across major mechanical categories. Increasing mechanical disruption does not necessarily enhance cell recovery. To enhance reproducibility and facilitate clinical translation, future research should prioritize standardized reporting frameworks and direct head-to-head scalability studies.