From the Guidelines
Emcyte protocols for preparing leukocyte-rich (LR-PRP) and leukocyte-poor PRP (LP-PRP) involve specific centrifugation parameters and processing steps, with the choice between them depending on the clinical application, as suggested by the studies 1.
Key Considerations
- The purity of the final PRP preparation is crucial, including the concentration of red blood cells and white blood cells, as well as the presence of plasma 1.
- The content, purity, and biological properties of PRP vary widely and impact clinical efficacy, making standardization of methods essential 1.
- The role of leukocytes in PRP is still unclear but may have a significant impact on the biology of these preparations, including immune and antibacterial properties, and tissue healing 1.
Emcyte Protocol Details
- For LR-PRP, blood is collected in ACD-A anticoagulant tubes and centrifuged at approximately 1500-2000 RPM for 5 minutes, followed by a second centrifugation at 3000-3500 RPM for 5-7 minutes.
- For LP-PRP, the protocol is modified to extract only the plasma layer and upper portion of the buffy coat after the first spin, avoiding the deeper buffy coat that contains most white blood cells.
Clinical Application Considerations
- LR-PRP may be preferred for musculoskeletal applications where some inflammatory response is beneficial.
- LP-PRP is often used for aesthetic applications where inflammation is undesirable.
Outcome Prioritization
- The Emcyte system's ability to yield 4-7 times baseline platelet concentration with high viability is crucial for minimizing morbidity and mortality, and improving quality of life, as it ensures the delivery of a potent and effective PRP preparation 1.
From the Research
Emcyte Protocols for Leukocyte Rich and Poor PRP
- The preparation of leukocyte-rich platelet-rich plasma (L-PRP) and leukocyte-poor platelet-rich plasma (LP-PRP) involves different centrifugation protocols and conditions 2, 3, 4.
- A study found that twice centrifugation (800× g, 10 minutes for the first time and 1 100× g, 10 minutes for the second time) is an ideal and feasible centrifugation scheme for L-PRP preparation, resulting in a higher platelet recovery rate and enrichment coefficient 2.
- The inclusion of leukocytes in PRP can influence the growth factor and protease concentrations, with leukocyte-rich PRP having higher concentrations of PDGF-BB and VEGF, but lower concentrations of FGF-b 3.
- Leukocyte-poor PRP preparation methods have also been optimized, with studies showing that the preparer's experience does not significantly affect the quality of prepared PRP, but the activation method used can impact the release of growth factors 4.
Comparison of Leukocyte Rich and Poor PRP
- A study compared the biological characteristics of L-PRP, LP-PRP, and pure-PRP, finding that the leukocyte concentration was dramatically different between the three groups, with L-PRP having the highest leukocyte concentration 3.
- Another study found that the inclusion of leukocytes in PRP can stimulate a more pro-inflammatory environment and alter fibrin properties, with L-PRP scaffolds releasing higher concentrations of pro-inflammatory cytokines under inflammatory conditions 5.
- The optimal composition of PRP for the treatment of tendinopathy has been investigated, with studies suggesting that leukocyte-reduced PRP may be the optimum preparation to stimulate superior healing without scar tissue formation 6.
Factors Affecting PRP Preparation
- The preparation quality of PRP is affected by various factors, including centrifugal force, centrifugal time, temperature, and operation process 2.
- The platelet and leukocyte concentrations in PRP can be influenced by the centrifugation protocol and conditions used, as well as the activation method employed 3, 4.
- The release of growth factors from PRP can be impacted by the leukocyte concentration and composition, with L-PRP having higher concentrations of certain growth factors 3.