Principles and Methods of Preparation of Platelet-Rich Plasma: A Review and Author's Perspective

Rachita Dhurat, Ms Sukesh, Rachita Dhurat, Ms Sukesh

Abstract

The utility of platelet-rich plasma (PRP) has spanned various fields of dermatology from chronic ulcer management to trichology and aesthetics, due to its role in wound healing. Though PRP is being used over a long time, there is still confusion over proper terminology to define, classify and describe the different variations of platelet concentrates. There is also a wide variation in the reported protocols for standardization and preparation of PRP, in addition to lack of accurate characterization of the tested products in most articles on the topic. Additionally, the high cost of commercially available PRP kits, precludes its use over a larger population. In this article, we review the principles and preparation methods of PRP based on available literature and place our perspective in standardizing a safe, simple protocol that can be followed to obtain an optimal consistent platelet yield.

Keywords: Platelet-rich plasma; preparation; principles; standardization.

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Flowchart describing preparation of PRP
Figure 2
Figure 2
Venipuncture using BD Eclipse™ blood collection needle
Figure 3
Figure 3
Consistency of PRP yield

References

    1. Conley CL. Hemostasis. In: Mountcastle VB, editor. Medical Physiology. St. Louis: The C.V. Mosby Company; 2004. pp. 1137–46.
    1. Harrison P, Cramer EM. Platelet alpha-granules. Blood Rev. 1993;7:52–62.
    1. Schliephake H. Bone growth factors in maxillofacial skeletal reconstruction. Int J Oral Maxillofac Surg. 2002;31:469–84.
    1. Sunitha Raja V, Munirathnam Naidu E. Platelet-rich fibrin: Evolution of a second-generation platelet concentrate. Indian J Dent Res. 2008;19:42–6.
    1. Cole BJ, Seroyer ST, Filardo G, Bajaj S, Fortier LA. Platelet-rich plasma: Where are we now and where are we going? Sports Health. 2010;2:203–10.
    1. Kevy SV, Jacobson MS. Comparison of methods for point of care preparation of autologous platelet gel. J Extra Corpor Technol. 2004;36:28–35.
    1. Marx RE. Platelet-rich plasma: Evidence to support its use. J Oral Maxillofac Surg. 2004;62:489–96.
    1. Antoniades HN, Williams LT. Human platelet-derived growth factor: Structure and functions. Fed Proc. 1983;42:2630–4.
    1. Marx RE. Platelet-rich plasma (PRP): What Is PRP and What Is Not PRP? Implant Dent. 2001;10:225–8.
    1. Rughetti A, Giusti I, D’Ascenzo S, Leocata P, Carta G, Pavan A, et al. Platelet gel-released supernatant modulates the angiogenic capability of human endothelial cells. Blood Transfus. 2008;6:12–7.
    1. Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: From pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF) Trends Biotechnol. 2009;27:158–67.
    1. Dohan Ehrenfest DM, Bielecki T, Mishra A, Borzini P, Inchingolo F, Sammartino G, et al. In search of a consensus terminology in the field of platelet concentrates for surgical use: Platelet-rich plasma (PRP), platelet-rich fibrin (PRF), fibrin gel polymerization and leukocytes. Curr Pharm Biotechnol. 2012;13:1131–7.
    1. Sweeny J, Grossman BJ. Blood collection, storage and component preparation methods. In: Brecher M, editor. Technical Manual. 14th ed. Bethesda MD: American Association of Blood Banks (AABB); 2002. pp. 955–8.
    1. Welsh WJ. Autologous platelet gel: Clinical function and usage in plastic surgery. Cosmetic Derm. 2000;11:13–9.
    1. Scherer SS, Tobalem M, Vigato E, Heit Y, Modarressi A, Hinz B, et al. Non-activated versus thrombin-activated platelets on wound healing and fibroblast-to-myofibroblast differentiation in vivo and in vitro. Plast Reconstr Surg. 2012;129:46e–54e.
    1. Platelet Rich Plasma (PRP) Guidelines, © International Cellular Medicine Society - 2011. [Last accessed 2014 Dec 5]. Available from: .
    1. Marlovits S, Mousavi M, Gabler C, Erdös J, Vécsei V, et al. A newsimplified technique for producing platelet-rich plasma: A short technical note. Eur Spine J. 13:102–06.
    1. Waters JH, Roberts KC. Database review of possible factors infuencing point-of-care platelet gel manufacture. J Extra Corpor Technol. 2004;36:250–4.
    1. Lozada JL, Caplanis N, Proussaefs P, Willardsen J, Kammeyer G. Platelet-rich plasma application in sinus graft surgery: Part I--background and processing techniques. J Oral Implantol. 2001;27:38–42.
    1. Han B, Woodell-May J, Ponticiello M, Yang Z, Nimni M. The effect of thrombin activation of platelet-rich plasma on demineralized bone matrix osteoinductivity. J Bone Joint Surg Am. 2009;91:1459–70.
    1. Amable PR, Carias RB, Teixeira MV, da Cruz Pacheco I, Corrêa do Amaral RJ, Granjeiro JM, et al. Platelet-rich plasma preparation for regenerative medicine: Optimization and quantification of cytokines and growth factors. Stem Cell Res Ther. 2013;4:67.
    1. Perez AG, Lana JF, Rodrigues AA, Luzo AC, Belangero WD, Santana MH. Relevant aspects of centrifugation step in the preparation of platelet-rich plasma. ISRN Hematol. 2014;2014:176060.
    1. Kahn RA, Cossette I, Friedman LI. Optimum centrifugation conditions for the preparation of platelet and plasma products. Transfusion. 1976;16:162–5.
    1. Slichter SJ, Harker LA. Preparation and storage of platelet concentrates. I. Factors influencing the harvest of viable platelets from whole blood. Br J Haematol. 1976;34:395–402.
    1. Landesberg R, Roy M, Glickman RS. Quantification of growth factor levels using a simplified method of platelet-rich plasma gel preparation. J Oral Maxillofac Surg. 2000;58:297–301.
    1. Jo CH, Roh YH, Kim JE, Shin S, Yoon KS. Optimizing platelet-rich plasma gel formation by varying time and gravitational forces during centrifugation. J Oral Implantol. 2013;39:525–32.
    1. Bausset O, Giraudo L, Veran J, Magalon J, Coudreuse JM, Magalon G, et al. Formulation and storage of platelet-rich plasma homemade product. Biores Open Access. 2012;1:115–23.
    1. Montalvo S, Tresguerres I, Tamini FM, Blanco Jerez L. A comparative study of 2 methods for obtaining platelet rich plasma. J Oral Maxillofac Surg. 2007;65:1084–93.
    1. Mazzocca AD, McCarthy MB, Chowaniec DM, Cote MP, Romeo AA, Bradley JP, et al. Platelet-rich plasma differs according to preparation method and human variability. J Bone Joint Surg Am. 2012;94:308–16.
    1. Anitua E, Aguirre JJ, Algorta J, Ayerdi E, Cabezas AI, Orive G, et al. Effectiveness of autologous preparation rich in growth factors for the treatment of chronic cutaneous ulcers. J Biomed Mater Res B Appl Biomater. 2008;84:415–21.
    1. Dugrillon A, Eichler H, Kern S, Klüter H. Autologous concentrated platelet-rich plasma (cPRP) for local application in bone regeneration. Int J Oral Maxillofac Surg. 2002;31:615–9.
    1. Araki J, Jona M, Eto H, Aoi N, Kato H, Suga H, et al. Optimized preparation method of platelet-concentrated plasma and noncoagulating platelet-derived factor concentrates: Maximization of platelet concentration and removal of fibrinogen. Tissue Eng Part C Methods. 2012;18:176–85.
    1. Fernández-Barbero JE, Galindo-Moreno P, Ávila-Ortiz G, Caba O, Sánchez-Fernández E, Wang HL. Flow cytometric and morphological characterization of platelet-rich plasma gel. Clin Oral Implants Res. 2006;17:687–93.
    1. Su CY, Kuo YP, Nieh HL, Tseng YH, Burnouf T. Quantitative assessment of the kinetics of growth factors release from platelet gel. Transfusion. 2008;48:2414–20.
    1. Kececi Y, Ozsu S, Bilgir O. A cost-effective method for obtaining standard platelet-rich plasma. WOUNDS. 2014;26:232–8.
    1. Chapter 17. 1st edition. 2014. Bentleys textbook of pharmaceutics -An update, Sanjay Kumar Jain, Vandana Soni; pp. 556–65.
    1. Macey M, Azam U, McCarthy D, Webb L, Chapman ES, Okrongly D, et al. Evaluation of the anticoagulants EDTA and citrate, theophylline, adenosine, and dipyridamole (CTAD) for assessing platelet activation on the ADVIA 120 hematology system. Clin Chem. 2002;48:891–9.
    1. Anitua E, Prado R, Sánchez M, Orive G. Platelet-rich-plasma: Preparation and formulation. Oper Tech Orthop. 2012;22:25–32.
    1. Callan MB, Shofer FS, Catalfamo JL. Effects of anticoagulant on pH, ionized calcium concentration, and agonist-induced platelet aggregation in canine platelet-rich plasma. American journal of veterinary research. 2009;70:472–7. doi:10.2460/ajvr.70.4.472.
    1. Guder WG, Narayanan S, Wisser H, Zawta B. Special Aspects of Haematological Analysis: Diagnostic Samples: From the Patient to the Laboratory: The Impact of Preanalytical Variables on the Quality of Laboratory Results. 4th ed. Wiley - Blackwell Publications; 2009. pp. 36–7.
    1. Weibrich G, Hansen T, Kleis W, Buch R, Hitzler WE. Effect of platelet concentration in platelet-rich plasma on peri-implant bone regeneration. Bone. 2004;34:665–71.
    1. Woodell-May JE, Ridderman DN, Swift MJ, Higgins J. Producing accurate platelet counts for platelet rich plasma: Validation of a hematology analyzer and preparation techniques for counting. J Craniofac Surg. 2005;16:749–59.

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