Basic concepts of autologous platelet concentrate preparation

Abstract

The application of PRP products has gained vast popularity in a number of clinical fields of medicine—dermatology, orthopedics, sports traumatology, aesthetic and plastic reconstructive surgery, neurosurgery, maxillofacial surgery, cardiac surgery and others. As their use in practice increases, many existing techniques for preparation become obvious. A basic difference in the methods of extraction of autologous platelet concentrates is the use of standard laboratory centrifuges and consumables or the extraction through variety of commercial systems with specific kits. There are a lot of factors that affect the quality of PRP products—type of anticoagulant, number of centrifugations (spins), time of rotation and centrifugal force and the activator that is used. Differences in these factors lead to products with variations in platelet counts and the presence or absence of leukocytes. This in turn is essential for the levels of growth factors, which are a key element in the recovery process. The main growth factors released by platelet α-granules after activation are: platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), transforming growth factor-β (TGF-β), insulin-like growth factor (IGF), and epidermal growth factor (EGF). An important characteristic of PRP is that it represents an autologous product, which is prepared from the patient’s own blood. Therefore, the use of autologous PRP eliminates any concerns about the risk of cross-contamination, disease transmission or immune reactions. By using different methods, it is possible to get various PRP types in regard to the content of bioactive molecules. Beside platelets as a dominant PRP element, other bioactive factors may also be involved in the immune response modulation process.