Commercial Separation Systems Designed for Preparation of Platelet-Rich Plasma Yield Differences in Cellular Composition
- 543 Downloads
The role of platelet-rich plasma (PRP) in the treatment of sport-related injuries is unclear, largely due to the heterogeneity of clinical results. This may relate to compositional differences in PRP from different separation systems.
This study aims to compare the composition of PRP produced with five different commercially available systems, focusing on cellular concentrations and pH.
Seven donors (41 ± 12 years) provided blood for PRP preparation using five systems (Arthrex Angel, Emcyte Genesis CS, Arteriocyte Magellan, Harvest SmartPrep, and Biomet GPS III). Post processing, cellular composition was measured including platelets (PLT), white blood cells (WBC), neutrophils (NE), and red blood cells (RBC), as well as pH.
Platelet concentration and capture efficiency were similar between systems, except the Angel 7% preparation had a greater concentration than Genesis CS (2310 ± 524 vs. 1129 ± 264 k/μL). WBC concentration was variable between systems; however, significant differences were only found between the Angel 2% and GPS III preparations (11.0 ± 4.5, 27.3 ± 7.1 k/μL). NE concentration was significantly lower in the Angel 2% and 7% preparations compared with GPS III (0.6 ± 0.6 and 1.8 ± 1.3 k/μL vs. 9.4 ± 7.0 k/μL). RBC concentration was highest in SmartPrep (3.2 ± 0.6 M/μL) and Genesis CS systems (3.1 ± 0.6 M/μL) compared with all other systems (≤1.1 ± 1.2 M/μL). Finally, pH was significantly lower with the SmartPrep system (6.95 ± 0.06) compared with all others (≥7.26 ± 0.06).
Aside from platelet concentration and capture efficiency, significant compositional differences were identified between preparation systems. Caution should be employed when interpreting clinical results of studies utilizing PRP, as the role of compositional differences and their effect on outcome are unknown. Further study is necessary to determine the clinical significance of these differences.
Keywordsplatelet-rich plasma platelet-rich plasma separation system cellular concentration
Compliance with Ethical Standards
Conflict of Interest
Ryan M. Degen, MD, Johnathan A. Bernard, MD, and Kristin S. Oliver, MD have declared that they have no conflict of interest. Joshua S. Dines, MD reports personal fees from Arthrex, Conmed Linvatec and Ossur, outside the work.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).
Informed consent was obtained from all patients for being included in the study.
Required Author Forms
Disclosure forms provided by the authors are available with the online version of this article.
- 1.Anitua E, Zalduendo MM, Prado R, Alkhraisat MH, Orive G (2015) Morphogen and proinflammatory cytokine release kinetics from PRGF-Endoret fibrin scaffolds: Evaluation of the effect of leukocyte inclusion. J. Biomed. Mater. Res. A 103:1011–1020.Google Scholar
- 5.Cepeda MS, Tzortzopoulou A, Thackrey M, Hudcova J, Arora Gandhi P, Schumann R (2012) Cochrane Review: Adjusting the pH of lidocaine for reducing pain on injection. Evidence-Based Child Heal. 7:149–215.Google Scholar
- 6.Cervellin M, de Girolamo L, Bait C, et al. Autologous platelet-rich plasma gel to reduce donor-site morbidity after patellar tendon graft harvesting for anterior cruciate ligament reconstruction: a randomized, controlled clinical study. Knee Surg Sports Traumatol Arthrosc. 2012; 20: 114-20.CrossRefPubMedGoogle Scholar
- 8.Dohan Ehrenfest DM, Andia I, Zumstein MA, et al. Classification of platelet concentrates (Platelet-Rich Plasma-PRP, Platelet-Rich Fibrin-PRF) for topical and infiltrative use in orthopedic and sports medicine: current consensus, clinical implications and perspectives. Muscles Ligaments Tendons J. 2014; 4: 3-9.PubMedPubMedCentralGoogle Scholar
- 11.Giovanini AF, Deliberador TM, Tannuri Nemeth JE, et al. Leukocyte-platelet-rich plasma (L-PRP) impairs the osteoconductive capacity of the autograft associated to changes in the immunolocalization of TGF-β1 and its co-expression with Wnt10b and CD34 cells. J Craniomaxillofac Surg. 2013; 41: e180-6.CrossRefPubMedGoogle Scholar
- 14.Jenis LG, Banco RJ, Kwon B (2006) A prospective study of Autologous Growth Factors (AGF) in lumbar interbody fusion. Spine J. 6:14–20.Google Scholar
- 29.Peerbooms JC, Sluimer J, Bruijn DJ, et al. Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. Am J Sports Med. 2010; 38: 255-62.CrossRefPubMedGoogle Scholar