Review of concentration yields in commercially available platelet-rich plasma (PRP) systems: a call for PRP standardization

Abstract

Platelet-rich plasma (PRP) has become increasingly popular in pain medicine with hopes of becoming a safe, effective alternative to routine treatments. However, given its autologous nature, PRP injectate may differ depending on the specific manufacturer and protocol. Currently, there is no standardization of reporting protocol. This systematic review compiles and standardizes values on PRP preparation and final product composition of platelets, white cell count, and growth factors for ease of comparison. On review of 876 studies, 13 studies were selected according to our inclusion criteria. Data from 33 PRP systems and protocols were extracted and standardized. Overall, PRP final product concentrations as well as PRP preparation protocols varied widely between systems. However, platelet concentration was directly correlated with both volume of blood collected and device centrifugal force. In conclusion, there is a large heterogeneity between PRP separation systems that must be resolved for proper study of this promising treatment.

Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020

“…Differences in the G -force and centrifugation time result in significant differences in yields, concentration, purity, viability, and activation status of the isolated platelets. Many types of commercial PRP preparation devices are available in the latter category, resulting in further variations in product content [ 35 ].…”

Pure platelet-rich plasma facilitates the repair of damaged cartilage and synovium in a rabbit hemorrhagic arthritis knee model

“…To the best of our knowledge, a standard regimen for the components of PRP has not been established yet. Platelet concentrations between one to nine times higher than whole blood were used in the previous studies in tissue healing and three to four times higher than the baseline that was recommended in knee arthritis and tendinopathies [28]. In this study, the average concentration of platelets in the P-PRP was 790.25 (95%CI, 742.04-838.45) × 10 6 platelets/mL, which was about three times higher than its concentration in the whole blood and was found to be effective for the treatment of HA.…”

Studies on platelet rich plasma - new editorial policy for “Platelets”

“…(10) Whether the PRP is activated prior to application either in vitro or in vivo, including the method used to activate the platelets before use and whether this converts plasma fibrinogen to form fibrin rich clots. (11) The method and number of in vivo applications, the specific delivery sites and volume of PRP administered,…”

“…Given the growth of interest, a number of commercial devices are also increasingly available for preparing sterile PRP for clinical therapies. As these devices often use different separation principles, the resulting PRP preparations are not standardized across different devices and therefore exhibit varying quantities, purity and quality of the platelets obtained [11]. For example, many products often contain plasma but may sometimes also contain both white and red cells.…”