Purpose: This study compared two methods of preparing platelet-rich plasma (PRP) gel and the levels of PDGF and TGF in each preparation.
Materials and Methods:Platelet-rich plasma gel was prepared by centrifugation and clotted using the ITA gelling agent (Natrex Technologies Inc, Greenville, NC) or by the addition of thrombin and calcium chloride. The levels of platelet-derived growth factor (PDGF) and transforming growth factor beta (TGF) generated by clot formation were assayed by enzyme-linked immunoassay (ELISA).Results: Both methods of preparation yielded PRP gel in less than 30 minutes. However, the ITA preparation did not require thrombin to achieve adequate gel formation. The levels of PDGF and TGF were similar regardless of which method was used for initiation of clot formation.
Conclusion:Use of ITA for gel preparation is equivalent to using calcium chloride and thrombin, without the need for special equipment and the risk of coagulopathy.Platelet-rich plasma (PRP) gel is derived from an autogenous preparation of concentrated platelets. PRP gel has numerous applications, particularly in the cardiac and neurosurgical areas. 1,2 Recently it has undergone a significant increase in use as an adhesive with cancellous bone particles in oral and maxillofacial surgery bone grafting procedures. 3,4 The traditional method of PRP preparation involves isolating platelets with a cell separator (Medtronics, Parker, CO), followed by gel formation using calcium chloride and bovine thrombin. This procedure has several disadvantages. The equipment necessary is expensive and is generally available only in an operating room or blood bank facility, making the use of PRP in a private office extremely difficult. Furthermore, the use of bovine thrombin has been associated with the development of antibodies to clotting factors V, XI, and thrombin, resulting in the risk of life-threatening coagulopathy. 1,2,5-7 We describe a new method to prepare PRP gel using a simplified armamentarium of equipment and supplies. This procedure can be used in an office setting and will yield an adequate amount of PRP gel for most minor bone grafting procedures. Additionally, this method uses an alternative to thrombin for gelling of the PRP, making it a safer preparation than that currently available.PRP is known to contain a number of growth factors/cytokines that may aid in the accelerated maturation of a bone graft. 4 Although platelet-derived growth factor (PDGF) and transforming growth factor- (TGF) have been identified in PRP gel, the amounts have not been quantified. It is also unclear as to whether the method used to gel the PRP affects the amount of growth factors/cytokines released from the platelets. We therefore compared the levels of PDGF and TGF generated from PRP prepared with the ITA gelling agent (Natrex Technologies Inc, Greenville, NC) and the thrombin/calcium chloride method.