A retrospective analysis of a commercially available platelet‐rich plasma kit during clinical use

Abstract

Introduction: Point-of-care analyses of platelet-rich plasma (PRP) are not routine in the orthopedic regenerative medicine field. Therefore, many physicians rely on the manufacturer's reported content for commercial preparation kits. This contributes to a knowledge gap between injectate content and patient outcome.Objective: To assess whether the EmCyte PurePRP II 60-mL preparation kit returns PRP content that meets the manufacturer's expectations when used during routine clinical care for a heterogenous patient population, and to determine whether a change in PRP yield volume affects injectate content. Protocol A (exclusion of granulocytes and low hematocrit) and Protocol B (inclusion of granulocytes and higher hematocrit) were evaluated. Design: Retrospective review. Setting: Private practice. Participants: One hundred five patients (118 preparations) treated for orthopedic conditions over an 8-month period via PRP injection. Thirteen patients had two independently made preparations on different treatment days that qualified for analysis. Interventions: Not applicable. Main Outcome Measures: Complete blood count (absolute counts and calculated fold enrichment from baseline of platelets, white blood cells, red blood cells, granulocytes, lymphocytes, monocytes; and hematocrit levels). Confounding variables included age, gender, and preparation yield volume. Results: During routine clinical use, the cellular content of both Protocols A and B met or exceeded the manufacturer's expectations of platelet enrichment and granulocyte inclusion or exclusion. Hematocrit values were slightly higher than anticipated from Protocol A preparations. The modification of yield volume from 7 to 4 mL led to a significant difference in platelet enrichment without affecting absolute cell counts (2.88; 95% confidence interval [CI] 1, 4.76; P = .003). Both gender and age moderately affected the level of platelet enrichment from baseline but did not significantly affect absolute platelet counts. Conclusion: In the absence of widespread characterization, confirming the variation in commercial PRP kits during clinical use is crucial.

Clinical outcomes following intradiscal injections of higher-concentration platelet-rich plasma in patients with chronic lumbar discogenic pain

“…Briefly, for each level injected, 60 ml peripheral blood was drawn and processed down to 4 ml PRP. This yielded platelet counts that were increased by at least 10 × , as previously shown [ 15 ]. A small 3-ml syringe was used to slowly inject the PRP (2 ml per disc) at low pressures over one to two minutes.…”

“…PRP was prepared as previously described [ 15 ]. Briefly, for each level injected, 60 ml peripheral blood was drawn and processed down to 4 ml PRP.…”

“…We have previously analyzed the cellular content of PRP that was processed from 118 patients using an Emcyte PurePRP II kit. Greater than tenfold (> 10 ×) increases in platelet concentration were observed in the PRP that was injected in the majority of patients [ 15 ]. No study has evaluated patient-reported outcomes following intradiscal injections of PRP with higher platelet concentrations.…”

Not all platelet-rich plasma are created equal

“…However, the advantage lies in standardized protocols offered by each brand, ensuring homogeneity in preparation, and typically featuring a quicker procedure. Well established brands such as Emcyte [35], Regenlab [36], BTI [37], Arthrex [7], Biomet Inc. [38], among others, are recognized for producing quality kits, each with unique protocol characteristics.…”

Application of platelet-rich plasma in spinal surgery

“…Different brands have developed different separation methods, and the content of the extracted PRP component is also different. Therefore, the best kit can be selected for extraction according to different therapeutic requirements ( 30 ).…”