GS60 544E -  Standard PRP 60mL

GS30 544E - Standard Platelet Concentrating System 30mL

GS60 544E- Standard Platelet Concentrating System 60mL

GS120 544E - Standard Platelet Concentrating System 120mL






Discussion



Four of the most frequently used point-of-care autologous PRP systems were compared. All four systems are centrifuge based, and with the exception of loading the disposable with anticoagulated blood and harvesting the PRP product, the separations are automated.  All systems concentrate platelets and WBC to varying degrees.  Part of the variance was related to efficiency of platelet recovery and part was due to the volume of the PRP product produced.  PRP volume collected can be adjusted during collection continuously on the Genesis system and in discrete increments of 1mL, 7 mL on the Harvest APC system. The Biomet GPSIII system is essentially fixed in PRP volume all though all PRP could be further diluted with the PRP fraction. The Arthrex ACP system contained the lowest concentration of WBC and platelets, with a mean platelet concentration of 70% greater than baseline levels. With respect to efficiency of platelet recovery, the GenesisCS and systems excelled with an average of 80% platelet yield across 3 donors. The highest yields were seen with the Genesis system; however the Smart PreP2 APC system was slightly more consistent between donors as reflected in the greater difference in sample median vs. sample mean in Table V. ​


All systems recovered viable platelets, with an average process dependent platelet activation of approximately 10%. The Biomet GPSIII system demonstrated the least process dependent activation, but only recovered approximately half of the platelets. ​


The measured concentration of growth factors, PDGF-A/B, TGF-β1, VEGF, and SDF-1α were all highest in the PRP produced with the GenesisCS system. The releasate concentrations of PDGF-A/B, TGF-β1 and to a lesser extent SDF-1α, correlate with the platelet count in the PRP.  VEGF concentrations are influenced by both platelet and WBC concentrations.  The efficiency of platelet and WBC recovery, the ability of the recovered platelets to retract the thrombin clot and ration of PRP volume to processed volume effect these results. The Arthrex ACP system despite only a 4mL PRP volume, only processed 9mL of blood vs. 54 or 56 mL for the other systems. In addition the PRP from the Arthrex ACP system did not have significant concentrations of platelets or WBC. ​


There was a large variation in number of RBC in the PRP products across the platforms with GenesisCS> Smart PreP2 APC> GPSIII>ACP.  There has been no clinical data concerning adverse events due to RBC contamination in PRP and as the RBC are autologous, there are no antigen cross match or agglutination issues. Furthermore, a typical pooled buffy coat platelet concentrate for transfusion has a hematocrit of approximately 50%.  In testing done in our laboratory, we have shown that contaminating RBCs do not activate platelets in PRP.

RESULTS:


​The concentration factor and yields in WBC, Platelet and hematocrit values for the samples collected are shown in the following Tables.

The 2015 PRP kits now offer a single, 5 minute spin for PRP.  This breakthrough in platelet harvesting technology is only offered through the Emcyte PRP Genesis system.


Four of the leading commercial systems for autologous PRP production were tested with paired samples such that blood from each of three donors was tested in duplicate runs with each system.  Table I lists the test device names, distributers, blood volume processed and the amount of anticoagulant used.

EMcYTE GenesisCS PRP  ​the  "FIVE MINUTE SPIN"  



Point of Care PRP Systems: