First stage : “Warm Ischemia” which the Graft is remaining at physiological temperature. This stage begins when we start to remove the tissue until it is put in the preserving solution (at 0-4 degree Celsius). Hair Follicle will be endangered by the Ischemic stage which affects the Oxygen, nutrition and blood supply for the cell. Hence, theanabolic metabolism is used to increase the level of Lactic and Hydrogen Ion. This will also affect the decrease of ATP (Adenosine Triphosphate) which lessen the energy transferred to the Cell as well as affect the balance of Cell’s acidity. From this action, Potassium will flow off the Cell, instead big volume of Sodium will flow in and the Cell will be swollen. It results the imbalance of Minerals and is dangerous for Cell. Once we cool down the Graft, it will be in cold Ischemic stage.

Second Stage : “Cold Ischemia” is when the Graft is remaining at lower physiological temperature. In this stage, the Ischemia is still remaining but the decrease of temperature will keep the Cell still and uses less energy. The solution used for Graft is effected its survival rate. When there is no oxygen in the Cell, the solution will keep the balance of Minerals between Cell and itself. We can say that the solution helps the Hair Follicle stayed safe until the Transplantation. During the process, the Cell might be, once again, jeopardized. It is called ‘Reperfusion Injury’ which is when blood supply nourishes Hair Follicle another time and Free Radicals might be produced. It could also harm the Cell.