Melanocyte keratinocyte transplantation offers promising procedural option for vitiligo

Key takeaways:

• Melanocyte keratinocyte transplantation can yield significant repigmentation ranging from 70% to 100%.
• The Recell device has minimized the time it takes to undergo this procedure from weeks to 1 day.

MIAMI BEACH, Fla. — When medical interventions fail, melanocyte keratinocyte transplantation may be the most advanced procedural option for vitiligo, according to a speaker at South Beach Symposium.

“Melanocyte keratinocyte transplantation (MKTP) is really where we are at with the most advanced procedural therapies for vitiligo,” Nada Elbuluk, MD, MSc, associate professor of dermatology at University of Southern California and founding director of the skin of color and pigmentary disorders program at Keck School of Medicine, said during her presentation. “And for those with segmental vitiligo, it is almost the closet thing to a cure.”

MKTP is an autologous procedure that is also known as noncultured epidermal cell suspension. Studies have shown that MKTP can yield significant repigmentation ranging from 70% to 100%.

While a widely effective treatment option, only certain patients make appropriate candidates.

“Procedural therapies are really reserved for a small subgroup of people,” Elbuluk said. “And it is important to know who those patients are because oftentimes we have patients who want quick treatments for their vitiligo asking about procedures, but we need to be able to guide them correctly.”

Candidates for MKTP can have either segmental or nonsegmental vitiligo; however, the disease must be refractory and stable.

“If it is not a patient that you’ve been seeing over time, you do need to ask these questions, get that history and even see if they have photos,” she stressed. “Because the last thing you will want to do is perform this procedure on a patient that has active vitiligo.”

Once the eligibility of the candidate is established, the next step to begin the procedure is harvesting a graft. The best donor sites for harvest are typically the thigh or buttock, Elbuluk explained.

To prep the recipient site for the transplant, it must be ablated with either dermabrasion or an ablative laser. Once the suspension from the donor site is ready, clinicians can pour it on the ablated site followed by a dressing that should remain on the site for about a week.

While previously considered tedious, this procedure has undergone major technological advancements that have made the process much more streamlined.

“Years ago, it used to take weeks and weeks to culture melanocytes,” Elbuluk said. “Nowadays you can do MKTP same day in office for patients.”

The technology credited with the advancement of MKTP is the Recell device (Avita), which was approved in June 2023 for the treatment of vitiligo. The Recell device requires a small area of donor skin to treat a much larger area of vitiligo allowing for a 1:20 ratio.

Furthermore, it can create a suspension in approximately 30 minutes and collects not only half a million viable melanocytes, but also keratinocytes and fibroblasts, according to Elbuluk.

“This is something that any practice can have,” Elbuluk said. “It is very doable, very easy to learn and very easy to use.”

Editor's note: On Feb. 8, the headline and a typo were corrected for accuracy. The editors regret the error.

Reference:

• RECELL autologous cell harvesting device (Model Number: AVRL0102). https://www.fda.gov/media/169638/download?attachment. Published June 16, 2023. Accessed Feb. 6, 2025.