PRP -Clinical evidence comparing commercial systems

“Characterisation and comparison of 5 Platelet-Rich Plasma Preparations in Single-Donor Model”

Magalon et al; 2014

Abs: compare characteristics of Platelet-Rich Plasma (PRP) obtained from 4 commercially available systems(Selphyl, Regen PRP, Mini GPS III, Arthrex ACP).

Blood collected from 10 healthy donors; Volumes, platelets, Red and White Blood Cell concentrations were recorded; platelet activation was assessed, Growth Factor (GFs) concentrations were measured; platelet capture efficiency, platelet and GF doses, and composition for each system was determined.

Leukocyte-Rich PRP (LR-PRP) for Regen and Mini GPS III systems, Leukocyte-Poor PRP (LP-PRP) for AngelACP and Selphyl; centrifugation time did not affect platelet activation percentage; positive correlation between platelet dose and GFs present.

 

Intro: healing process standard for most tissues; involves recruitment of platelets and release of GFs, that contribute to the reparative and restorative processes; PRP is suspension of platelets in plasma, with a higher platelet concentration than the baseline concentration in Whole Blood (WB); GFs present play major role in cell proliferation, cell differentiation, and blood vessel formation (“angiogenesis”); PRP obtained from centrifugation of patient’s WB, which is then re-injected at desired site; is in liquid form after centrifugation, can be made into gel by mixing with thrombin; it is an easy, fast, cheap and safe process.

16 systems available on the market, that differ in separation method, time and speed of centrifugation, and volume of WB used; difference in platelet concentration, presence of White Blood Cells, and in platelet activation. The final concentration of platelets must be anywhere between 1 to 6 times higher than the baseline value of WB; anything more can have a negative effect.

Study compares the properties of the PRP obtained by 4 different systems: Selphyl, Regen PRP, Mini GPS IIIand Arthrex ACP.

 

Methods:

  • 4 different systems.
  • 10 donors, all with baseline platelet concentration above .
  • Overall volume of WB used: 5mL (8mL Selphyl, 8mL Regen PRP, 27mL Mini GPS III, 11mL Angel ACP).

 

Results:

  • Volume of PRP after processing: highest in Angel ACP and Selphyl System.
  • Platelet capture efficacy and relative composition: Selphyl, Regen and Angel ACP rank 1st, 2nd and 3rdrespectively in platelet capture, but Angel ACP PRP has highest relative composition in platelets.
  • White Blood Cells, Neutrophils and Red Blood Cells: for all 3 components, both the Mini GPS III and Regen systems had the highest yield.
  • GFs presents were the same for all systems; individual concentrations did however vary from system to system.
  • PRP obtained from Angel ACP purest

 

Discussion: some noticeable differences in PRP preparation; spin time and speed, WB used, number of spins; each PRP produced has its own benefits that can then be used for specific applications; one common point between all systems is an initial soft spin to avoid platelet activation; LR-PRP have a leukocyte concentration higher than the baseline concentration in WB, which can be beneficial if a strong immune response is desired; LP-PRP have a leukocyte concentration below the one in WB, which is desirable if a supressed immune response is wanted; clear correlation between platelet dose and GFs concentration.

 

What to take away from this paper:

  • Many systems are available: must pick one that is suitable for desired application of PRP!
  • Angel system has real promise and is superior in main categories.
  • ACP is older system; the new Angel system is far better.