Ch 4 - Platelet-Rich Plasma Flashcards
What to the alpha granules of platelets contain?
Hundreds of growth factors, cytokines, vasoactive peptides, extracellular matrix proteins
Released upon platelet activation and are critically important in all phases of wound healing
What should the platelet concentration of PRP be in comparison to peripheral blood?
At least 3-5 times higher
What else does PRP contain?
- Clotting factors
- Plasma proteins
- antibacterial and fungicidal effects
- membrane glycoproteins which influence inflammation
- 800 unique proteins
Depending on preparation method, also potential for leukocyte isolation to occur resulting in leukocyte- and platelet-rick plasma (L-PRP)
How does PRP act?
Increases the proliferation of mesenchymal stem cells and fibroblasts in a dose-dependant manner. TGF-B within PRP increases collagen type 1 production in tendons
How is PRP osteopromotive?
Chondropromotive?
- Stimulates the production of osteoclast-like cells
- Platelets contain a number of grwoth factors to initiate bone healing - PDGF, TGF-B, VEGF, BMP
Chondro:
- Significant increased in chondrocyte proliferation and celular accumulation of GAGs and collagen tpe 2 in porcine chondrocytes with platelet lysate
How do you prepare PRP?
Classic 2-step centrifugation method:
- 10-110ml whole blood
- anticoagulant
- soft spin
- plasma and uppermost layer of buffy coat transferred
- second, longer hard spin
- Majority of platelet-poor plasma is discarded and the pellet is resuspended forming PRP
If you use the entire buffy coat, will get L-PRP
Gravity-filtration method
- 60ml anticoagulated blood in reservoir bag mixed with sterile water leading to platelet swelling
- Passed through a filter
- platelets, erythrocytes and some leukocytes captures
- Sterile saline flushed back through to filter resulting in leukocyte- and platelet-rich preparation (but NOT plasma)
List 2 contraindications of PRP treatment
- Thrombocytopaenia
- Coagulation defects
