Abstract
Platelet-rich plasma (PRP) is usually described with respect to its platelet concentration and sometimes the concentration of erythrocytes and leukocytes. In this study, we examined the numbers of leukocyte subtypes in PRPs prepared by five different methods. Single spin PRP methods evaluated resulted in a significant increase in the percentage of lymphocytes and proportional/inverse reduction of the percentage of granulocytes in comparison to those percentages found in whole blood. We propose that the centrifugation process traps the denser granulocytes in the RBC layer more readily than lymphocytes and that this will vary by g force and time. The PRP preparation method may be clinically relevant, because the distribution of leukocytes may affect clinical outcomes.
Highlights
The differences in outcomes of clinical trials with platelet-rich plasma (PRP) have been attributed to variability in the composition of PRP
We investigated the change in percentage of lymphocytes, total eosinophil (MID), and granulocytes found in whole blood complete blood count (CBC) and prepared PRP for five different methods of preparation: machine method (MA), double syringe (DS), single syringe (SS), gel tube (GT), and yellow top tube (YTT)
Including the Red blood cell count (RBC) count as a covariate in analysis, all PRP parameters were significantly different between methods (p < 0.001 for all parameters except MIDs [p = 0.33]) and the change between whole blood and PRP was significant between methods for all parameters measured (p < 0.001) except for MIDs (p = 0.28)
Summary
The differences in outcomes of clinical trials with platelet-rich plasma (PRP) have been attributed to variability in the composition of PRP. Several PRP classification systems have been promulgated in order to decrease the confusion surrounding the definition of PRP [1,2,3,4]. These systems typically include platelet count, erythrocyte count, leukocyte count and the addition of activating factors to the PRP. The classification systems have not, discriminated between the subtypes of leukocytes. In a previously published study comparing various methods of PRP preparation for comparative platelet yield, that there appeared to be a difference in the percentage of leukocyte subtypes between whole blood and PRP [5]. Carr et al in 2016 noted a significant change in concentrations of lymphocytes and neutrophils in PRP made from canine blood by five different methods [6] and Baria et al in 2019 [7] measured an increase in PRP lymphocytes and decrease in neutrophils when preparing PRP in the same system we used for our machine method ( using different settings)
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