Abstract
Background: platelets are a rich source of various growth factors and hence platelet rich plasma (PRP) is being used therapeutically in the fi eld of dermatology, orthopaedics and dentistry with promising results. However, methods of preparation of PRP vary with many commercial kits also available. Scoring systems like DEPA score, PAW system and sports medicine criteria score help in determining the quality of the fi nal product and guide therapy. Here we test a simple two step method for preparation of PRP and score it according to the abovementioned criteria while comparing it with the commercial kits analysed in literature. Methods: 10 ml whole blood was collected in 1.5 ml ACD solution from 100 healthy willing participants and analysed for platelet concentration. Sample was then centrifuged at 1600 rpm X 4 minutes in a calibrated laboratory centrifuge and supernatant was collected in a sterile tube using a sterile syringe. The supernatant was further concentrated for platelets by centrifuging at 3600 rpm X 10 minutes to form a platelet pellet at the bottom. All but 1 ml supernatant (Platelet defi cient plasma) was discarded and the platelet pellet was suspended again to form platelet rich plasma. Platelet count was estimated in this sample as done with the whole blood sample. The results were compared and analysed using statistical methods to determine the effi cacy of concentrating platelets by this method. Results: The tested method gave a fi nal concentration of more than four times the baseline concentration with approximately 30% effi ciency of capture and 80% purity. This was comparable to majority of the commercial systems tested in literature at a fraction of the cost. The scores according to various classifi cation systems were determined and reported. Conclusion: Every platelet rich plasma prepared for therapeutic purposes should be classifi ed according to any of the available scoring systems to determine its suitability for the purpose and to maintain uniformity in the quality of the product. The proposed two step method of preparation yields satisfactory quality of PRP by utilizing services of a basic laboratory at a fraction of the cost of commercial systems thereby enabling smaller medical institutions to utilize PRP therapy.
Highlights
Platelet rich plasma (PRP) has recently gained a lot of attention due to the fact that platelet granules contain a plethora of growth factors including platelet-derived growth factor, transforming growth factor beta 1, transforming growth factor beta 2, insulin-like growth factor, epidermal growth factor, epithelial cell growth factor (ECGF) etc[1]
As the use of PRP is growing exponentially because of the publicity and the easy availability, there needs to be a proper guideline for harvesting platelets from a small amount of blood and to classify the end product in a universal score to determine its quality before being used for a variety of therapeutic purposes including stimulating hair growth in cases of androgenic alopecia, hastening bone formation in cases of autologous bone grafting etc
PRP prepared from 100 samples by the proposed two step method was evaluated for quality and the following were observed (Figure 2)
Summary
Platelet rich plasma (PRP) has recently gained a lot of attention due to the fact that platelet granules contain a plethora of growth factors including platelet-derived growth factor, transforming growth factor beta 1, transforming growth factor beta 2, insulin-like growth factor, epidermal growth factor, epithelial cell growth factor (ECGF) etc[1]. Commercially available kits have sprung up which guarantee a higher yield of platelets from a small amount of blood but incur a high cost of production[14]. As the use of PRP is growing exponentially because of the publicity and the easy availability, there needs to be a proper guideline for harvesting platelets from a small amount of blood and to classify the end product in a universal score to determine its quality before being used for a variety of therapeutic purposes including stimulating hair growth in cases of androgenic alopecia, hastening bone formation in cases of autologous bone grafting etc. Studies have proposed different characterisation criteria for PRP like the DEPA classification which takes the following parameters into account: (1) Dose of injected platelets, (2) Efficiency of production, (3) Purity of PRP and (4) Activation process (Table 1). It should be assessed and reported while classifying the end product as either below baseline or above baseline WBC levels
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