Platelet Rich Plasma (PRP) Sequestration Why, When, How?

Abstract

Reduction in the amount of blood products transfused during and following any surgery is vitally important because of the risk of blood-transmitted diseases and the increasing costs associated with any transfusion. During the 1970s, a technique of sequestering (drawing off and storing) a patient's blood in the operating room evolved in cardiac surgery. This procedure involved the removal of one or two units of whole blood into anticoagulated storage bags prior to going on cardiopulmonary bypass. This autologous blood was stored in the operating room at room temperature until the patient was brought off cardiopulmonary bypass and stabilized. The blood was then reinfused into the patient. It was theorized that the blood withdrawn contained fresh platelets, red cells, and coagulation factors required to help restore hemostasis rapidly. Furthermore, oxygen carrying capacity following the operation was improved, thereby reducing the need for homologous blood product transfusions following the operation. An entirely new approach to reduction in the use of blood products involves the preoperative collection of Platelet Rich Plasma (PRP) and the subsequent reinfusion of the PRP containing fresh, undamaged platelets and clotting factors following the operation. This paper will document why the technique of utilizing Platelet Rich Plasma Sequestration is beneficial for the patient, when and where platelet rich plasma sequestration can be performed and, how the PRP procedure is technically performed.