scholarly journals Intraoperative collection of autologous platelet-rich plasma from the cardiopulmonary bypass circuit upon initiation of extracorporeal circulation

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Takeshi Honda ◽  
Yuji Kanaoka ◽  
Hiroshi Furukawa ◽  
Taishi Tamura ◽  
Noriaki Kuwada ◽  
...  
Keyword(s):  
Platelet Count ◽  
Cardiopulmonary Bypass ◽  
Platelet Aggregation ◽  
Platelet Rich Plasma ◽  
Adenosine Diphosphate ◽  
Collection System ◽  
Blood Samples ◽  
Autologous Platelet Rich Plasma ◽  
The Mean ◽  
Autologous Platelet

Abstract Objectives The aim of this study is to evaluate the possibility of the autologous platelet-rich plasma (PRP) collection from the cardiopulmonary bypass (CPB) circuit and to evaluate its effect on the aggregative function. Methods For seventy-two patients undergoing cardiac surgery with CPB, an autologous PRP was prepared using the Haemonetics Component Collection System® by drawing blood from the CPB circuit immediately after CPB was established. The blood samples were taken at three points for examination, A: beginning of surgery, B: immediately after heparin reversal with protamine following discontinuation of CPB, C: after the collected autologous PRP was returned to the patient. Platelet count and platelet aggregation ability were analyzed. Results The mean platelet count in autologous PRP was 5.5 (range: 3–14) units. Platelet count decreased by 115.0 (±27.3) × 1000/μl from A to B and increased by 27.3 ± 17.2 (× 1000/μl) from B to C. When platelet aggregation was measured by Adenosine Diphosphate (ADP) 3.0 μM, it decreased by 42.6% ± 12.1% from A to B and increased by 8.7% ± 7.4% from B to C. Conclusions Autologous PRP can be safely collected by drawing blood from the CPB circuit, platelet count and aggregation ability significantly decreased after CPB including autologous PRP collection. Some improvement was detected in the number of the platelets count and platelet aggregation ability by administrating an autologous PRP even if autologous PRP is collected from CPB circuit. Trial registration UMI-CTR, UMIN000023776. Registered 1 October 2016.

Second Phase Platelet Aggregation Induced by Adenosine Diphosphate in Patients with Cerebral Vascular Disease and in Control Subjects

1970 ◽  
Vol 23 (01) ◽  
pp. 159-169 ◽  
Author(s):  
G Danta
Keyword(s):  
Platelet Count ◽  
Platelet Aggregation ◽  
Vascular Disease ◽  
Platelet Rich Plasma ◽  
Adenosine Diphosphate ◽  
Second Phase ◽  
Cerebral Vascular Disease ◽  
The Mean ◽  
Phase Platelet ◽  
Cerebral Vascular

SummaryAdenosine diphosphate-induced second phase platelet aggregation was studied in 70 patients with established cerebral vascular disease, 27 patients with chronic cerebral vascular disease taking dipyridamole, and 53 control subjects. The appearances of aggregation graphs relating changes in optical density in platelet-rich plasma to time after addition of adenosine diphosphate are described. An intermediate rate change in optical density was observed between first and second phase aggregation.Induction of second phase aggregation depends on the concentration of adenosine diphosphate and the platelet count of the plasma. Individual rseponses vary greatly, and there is appreciable variability in repeated estimations, but in the same plasma responses to adenosine diphosphate are accurately reproducible.In both patients and controls the mean logarithm of the adenosine diphosphate concentration that just induces second phase aggregation is inversely proportional to the mean platelet count of platelet-rich plasma. At all platelet concentrations studied, the smallest concentration of adenosine diphosphate that brought about second phase aggregation was significantly less in the patients than in controls. There was no significant correlation between the means of the two variables in patients taking dipyridamole. The findings in this group of patients accord with the assumption that dipyridamole favourably affects the abnormal reaction of platelets to adenosine diphosphate in some of the patients with cerebral vascular disease.

scholarly journals Intradiscal Injection of Autologous Platelet-Rich Plasma Releasate to Treat Discogenic Low Back Pain: A Preliminary Clinical Trial

2017 ◽  
Vol 11 (3) ◽  
pp. 380-389 ◽  
Author(s):  
Koji Akeda ◽  
Kohshi Ohishi ◽  
Koichi Masuda ◽  
Won C. Bae ◽  
Norihiko Takegami ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Platelet Rich Plasma ◽  
Low Back ◽  
Discogenic Low Back Pain ◽  
Intradiscal Injection ◽  
Autologous Platelet Rich Plasma ◽  
The Mean ◽  
Autologous Platelet

<sec><title>Study Design</title><p>Preliminary clinical trial.</p></sec><sec><title>Purpose</title><p>To determine the safety and initial efficacy of intradiscal injection of autologous platelet-rich plasma (PRP) releasate in patients with discogenic low back pain.</p></sec><sec><title>Overview of Literature</title><p>PRP, which is comprised of autologous growth factors and cytokines, has been widely used in the clinical setting for tissue regeneration and repair. PRP has been shown <italic>in vitro</italic> and <italic>in vivo</italic> to potentially stimulate intervertebral disc matrix metabolism.</p></sec><sec><title>Methods</title><p>Inclusion criteria for this study included chronic low back pain without leg pain for more than 3 months; one or more lumbar discs (L3/L4 to L5/S1) with evidence of degeneration, as indicated via magnetic resonance imaging (MRI); and at least one symptomatic disc, confirmed using standardized provocative discography. PRP releasate, isolated from clotted PRP, was injected into the center of the nucleus pulposus. Outcome measures included the use of a visual analog scale (VAS) and the Roland-Morris Disability Questionnaire (RDQ), as well as X-ray and MRI (T2-quantification).</p></sec><sec><title>Results</title><p>Data were analyzed from 14 patients (8 men and 6 women; mean age, 33.8 years). The average follow-up period was 10 months. Following treatment, no patient experienced adverse events or significant narrowing of disc height. The mean pain scores before treatment (VAS, 7.5±1.3; RDQ, 12.6±4.1) were significantly decreased at one month, and this was generally sustained throughout the observation period (6 months after treatment: VAS, 3.2±2.4, RDQ; 3.6±4.5 and 12 months: VAS, 2.9±2.8; RDQ, 2.8±3.9; <italic>p</italic>&lt;0.01, respectively). The mean T2 values did not significantly change after treatment.</p></sec><sec><title>Conclusions</title><p>We demonstrated that intradiscal injection of autologous PRP releasate in patients with low back pain was safe, with no adverse events observed during follow-up. Future randomized controlled clinical studies should be performed to systematically evaluate the effects of this therapy.</p></sec>

scholarly journals Intrauterine Infusion of Autologous Platelet-Rich Plasma Affects the Endometrial Thickness, Epidermal Growth Factor and Pregnancy Outcome in Patients Undergoing IUI

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Wafaa A. Abaid ◽  
◽  
Manal T. Al-Obaidi ◽  
Muayad S. Abood ◽  
◽  
...  
Keyword(s):  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Endometrial Thickness ◽  
Platelet Rich Plasma ◽  
Chorionic Gonadotrophin ◽  
Human Chorionic Gonadotrophin ◽  
Epidermal Growth ◽  
Autologous Platelet Rich Plasma ◽  
The Mean ◽  
Autologous Platelet

Despite developments in assisted reproductive technology, there is immaterial progress in the implantation and pregnancy rates. Intrauterine infusion (IUIF) of autologous platelet-rich plasma (PRP) might renew implantation rates through its paracrine properties by progression cytokines and growth factors which favor implantation. Here we determine whether the IUIF of autologous PRP had a role in pregnancy outcome through its outcome on epidermal growth factor and endometrial thickness. An overall of 43 patients where prospectively randomly dispersed into two groups subjected to a superovulation program using Letrozole® tablet orally 2.5 mg twice daily 12 hours apart from day 2 for 5 days for one cycle. 20 women were considered as control receiving the conventional intrauterine insemination (IUI) management while 23 of them were given PRP by IUIF on the day of human chorionic gonadotrophin injection. The IUI was done for both groups 36-48 hours after confirming ovulation. The blood samples were collected from both groups on the day of IUI for the valuation of epidermal growth factor and an ultrasound was done on the day of human chorionic gonadotrophin injection and day of IUI for assessment of endometrial thickness. The mean endometrial thickness in the PRP group at the day of IUI was significantly thicker than that of the control group and the difference in percentage change of endometrial thickness between PRP group and controls significantly higher in PRP group. The mean epidermal growth factor and the pregnancy rate were significantly superior in the PRP group than that of controls. In conclusion, autologous PRP IUIF was well-tolerated and resulted in a significant expansion in endometrial thickness, epidermal growth factor Level and, subsequent pregnancy rate in an infertile woman undergoing IUI.

Reduced Platelet Aggregation in Hemolytic-Uremic Syndrome

1980 ◽  
Vol 43 (02) ◽  
pp. 154-157 ◽  
Author(s):  
Bernard S Kaplan ◽  
Jack S C Fong
Keyword(s):  
Platelet Count ◽  
Platelet Aggregation ◽  
Hemolytic Uremic Syndrome ◽  
Early Phase ◽  
Platelet Rich Plasma ◽  
Adenosine Diphosphate ◽  
Normal Subjects ◽  
Platelet Poor Plasma ◽  
Platelet Counts ◽  
Uremic Syndrome

SummaryPlatelet aggregation was studied in three patients during the course of the hemolytic-uremic syndrome (HUS) when the platelet count was below 100,000/mm3 and after the platelet count had normalized. Platelet aggregation was examined in response to epinephrine, adenosine diphosphate (ADP) and collagen. Aggregation did not occur in response to epinephrine when the patients were thrombocytopenic but normal tracings were obtained when the platelet counts had returned to normal. In contrast, platelet-rich plasma from normal subjects diluted with platelet-poor plasma from patients to comparable platelet counts, showed normal aggregation responses. This study demonstrates that platelet aggregation is reduced in the early phase of the HUS.

Reversal Strategy For Antagonizing The P2Y12-Inhibitor Ticagrelor By Platelet Concentrates

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1153-1153
Author(s):  
Hobl Eva-Luise ◽  
Petra Jilma-Stohlawetz ◽  
Ulla Derhaschnig ◽  
Schoergenhofer Christian ◽  
Michael Schwameis ◽  
...  
Keyword(s):  
Platelet Aggregation ◽  
Whole Blood ◽  
Ex Vivo ◽  
Platelet Reactivity ◽  
Platelet Rich Plasma ◽  
Loading Dose ◽  
Platelet Concentrates ◽  
P2y12 Inhibitor ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

Abstract Background Patients on anti-platelet therapy have a higher incidence of bleeding complications and reversal of anti-platelet drug effects is an important issue in emergency situations. For old and conventional anti-coagulants, reversal strategies are established. However, there is no experience or recommendation how to antagonize the reversible and highly effective P2Y12-inhibitor ticagrelor and how to restore platelet function following ticagrelor dosing. The aim of this study was to investigate an ex vivo model to reverse the effects of ticagrelor and to estimate the optimal quantity of platelet transfusions required to normalize platelet aggregation. Methods Healthy volunteers (n=20) ingested a loading dose of 180 mg ticagrelor. Blood samples were obtained at baseline to gain autologous platelet rich plasma and to perform aggregation studies after 3h, i.e. at the time of expected maximal ticagrelor concentrations and maximimal platelet inhibition. To normalize platelet aggregation, increasing amounts of autologous platelet rich plasma (PRP) were added ex vivo to hirudin anti-coagulated blood, by spiking PRP into blood at ratios of 1:10, 1:5 and 1:3. Platelet aggregation was assessed by whole blood multiple electrode aggregometry (MEA; Multiplate). For interpretation of aggregation, we defined a cutoff level of 40 U (Units) as the lower limit of the normal range. Volunteers above this level were considered to exhibit normal platelet reactivity. Nonparametric tests were used and statistical comparisons were performed with the Friedman ANOVA, and the Wilcoxon test for post-hoc comparisons. A two-tailed p-value of less than 0.05 was considered significant. Results Ingestion of 180 mg ticagrelor reduced average aggregation responses from 71 to 16 A.U. (p<0.001) and the platelet reactivity index in the VASP-assay from 88 to 22 units (p<0.001) A clear dose-response was obtained after spiking whole blood with increasing amounts of PRP. After addition of PRP at a ratio of 1:10, platelet aggregation increased to 31±14 U. When assuming that one apheresis platelet concentrate (200 mL) typically contains a minimum of 2 x1011 platelets, the ratio of 1:10 corresponds to 0.5 units of apheresis platelet concentrates. A ratio of 1:5 – equivalent to 1 unit of platelet concentrates – increased ADP induced platelet aggregation to 41±14 U. Platelet aggregation increased further to 48±18 U following the addition of PRP at a ratio of 1:3, which corresponds to 1.5 units of platelet concentrates (figure 1). All comparisons were significant at p<0.01. Conclusion Platelets dose-dependently improved ex vivo platelet aggregation of subjects after a loading dose of 180 mg of ticagrelor. It is estimated that > 2 units of apheresis platelet concentrates will be necessary to completely restore baseline platelet aggregation in the majority of patients. Point-of-care platelet function tests may be suitable tools to verify this concept in emergency patients and to estimate the extent of the reversal and de-risk on an individual patient’s level. Disclosures: No relevant conflicts of interest to declare.

The haemostatic effectiveness of autologous platelet rich plasma sequestered after heparin administration and institution of cardiopulmonary bypass

Perfusion ◽  
1995 ◽  
Vol 10 (2) ◽  
pp. 101-110 ◽  
Author(s):  
RL Quigley ◽  
JA Perkins ◽  
JA Caprini ◽  
El Haney ◽  
SS Switzer ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Blood Loss ◽  
Platelet Rich Plasma ◽  
Homologous Blood ◽  
Homologous Blood Transfusion ◽  
Heparin Administration ◽  
Significant Difference ◽  
Autologous Platelet Rich Plasma ◽  
Induced Aggregation ◽  
Autologous Platelet

Preoperative harvesting and postoperative reinfusion of autologous platelet rich plasma (PRP) has been reported to decrease blood loss as well as the requirement for homologous blood transfusion following cardiopulmonary bypass (CPB). We have developed a technique of intraoperative PRP sequestration which occurs during the initial period of CPB after the patient's circulation is supported and heparin has been given (PRP+). This process does not require any additional hardware, personnel or expense and it is performed without difficulty or complication. To evaluate the effect of PRP+ sequestration and reinfusion on blood loss and homologous blood requirement after CPB, we randomly assigned 126 consecutive patients undergoing elective open heart surgery into the experimental group 1 (PRP+) (n = 64) or the control (no platelet pheresis) group 2 (n = 52). A third group (n = 10) were not included in the randomization. Patients in group 3 had PRP prepared by conventional techniques (PRPc) prior to heparin administration and given to the patient after protamine infusion. Aggregation and activation studies were performed on the PRP+, PRPc, and blood bank platelets (BBP). Per cent aggregation of PRP in response to ADP was superior to that of BBP. There were no significant differences in ADP induced aggregation between PRP+ and PRPc. There was no significant difference in platelet activation (CD62) or number between the three groups. Patients infused with PRP+ showed significantly increased aggregation to ADP when compared with untreated patients 120 minutes after return to the ICW. Furthermore, more homologous haemostatic components (platelets/fresh frozen plasma) were required in the control group. We have demonstrated that collection of autologous PRP+ after administration of heparin does not interfere with its haemostatic effectiveness compared with PRPc prepared before the initiation of bypass. Moreover, this can be performed universally in haemodynamically unstable patients without any additional costs.

scholarly journals Effect of autologous platelet-rich plasma in the promotion of healing of chronic ulcers

2017 ◽  
Vol 5 (1) ◽  
pp. 15 ◽  
Author(s):  
Mohamed M. Raslan ◽  
Nader M. Milad ◽  
Ahmed Abd AlAziz
Keyword(s):  
Platelet Rich Plasma ◽  
Case Series ◽  
Cost Effective ◽  
Complete Healing ◽  
Major Advance ◽  
Average Decrease ◽  
Chronic Ulcers ◽  
Autologous Platelet Rich Plasma ◽  
The Mean ◽  
Autologous Platelet

Background: Chronic ulcers are a big health problem worldwide. Having a great impact at personal, social and professional levels. The use of autologous Platelet Rich Plasma (PRP) is a major advance in the treatment of these ulcers as an easy and cost-effective method. Platelets provide numerous growth factors enhancing tissue healing. The aim of this study was to evaluate the safety and efficacy of autologous platelet-rich plasma as a treatment of chronic non-healing ulcers.Methods: Autologous PRP was prepared from whole blood by centrifugation and activated by 10% calcium chloride. Twenty-Four (24) patients with non-healing ulcers of different etiologies, whom they met our inclusion criteria, were treated with PRP injected every two weeks locally into their wounds until healing. The ulcer dimensions were measured every week. The follow-up period was 12 weeks after healing.Results: The mean age of the study population 41±21 years. Complete healing was achieved in all patients. The mean rate of healing (average decrease in ulcer dimensions) was 0.48 cm/week. The rate of healing was greater at the week following injection. The mean time for healing was 6.11 weeks.Conclusions: Author witnessed the useful effects of PRP application on enhancing wound healing. The results from our case series showed that PRP is a safe and effective treatment for the promotion of healing chronic ulcers. Further research and controlled, randomized prospective clinical trials on larger patient population are important to validate our results.

Free Platelet Count and Size Distribution During C1q Inhibition of Collagen-Induced Platelet Aggregation

1987 ◽  
Vol 58 (02) ◽  
pp. 682-685 ◽  
Author(s):  
Gyorgy Csako ◽  
Eva A Suba
Keyword(s):  
Platelet Count ◽  
Platelet Aggregation ◽  
Light Transmission ◽  
Platelet Rich Plasma ◽  
Inhibitory Effect ◽  
Lag Phase ◽  
Large Platelet ◽  
Median Volume ◽  
Platelet Aggregates ◽  
The Mean

SummaryElectronic free platelet counting was more sensitive than turbidimetry to detect collagen-induced platelet activation in human platelet-rich plasma. Purified human Clq exhibited a greater inhibitory effect on collagen-induced platelet aggregation in turbidimetry than free platelet counting. Because the change from small to large platelet aggregates is responsible for the continuing increase in light transmission, Clq was likely more capable of blocking the formation of large platelet aggregates than the formation of small aggregates from single platelets. The iattr uf change by cullagcn in light tiansmissiun and fiec platelet count was reduced in the presence of Clq but the timing of the peak response remained the same. Electronic platelet sizing revealed that the volume of single platelets transiently increased during the turbidimetric “lag phase”. The mean, mode and median volume of the remaining free platelets then decreased, suggesting a selective loss of large, functionally more active platelets and/or platelet degranulation. Clq had no effect on the volume increment during the “lag phase”, but reduced the subsequent fall in the volume of free platelets.

Studies of Platelet Aggregation, Plasma Adenosine Diphosphate Breakdown and Blood Coagulation in Magnesium Deficient Calves and Rats

1970 ◽  
Vol 23 (02) ◽  
pp. 299-305 ◽  
Author(s):  
M. M Stevenson ◽  
I. I Yoder
Keyword(s):  
Platelet Count ◽  
Platelet Aggregation ◽  
Platelet Rich Plasma ◽  
Serum Magnesium ◽  
Adenosine Diphosphate ◽  
Clinical Implications ◽  
Platelet Poor Plasma ◽  
Significant Difference ◽  
Procoagulant Effect ◽  
Plasma Adenosine

SummaryADP-induced platelet aggregation and the breakdown of ADP in platelet-poor plasma of normal and magnesium deficient calves and rats have been studied. There was no statistically significant difference in ADP-induced platelet aggregation between the treated and untreated groups of animals. There was a significant difference in the ADP breakdown in platelet poor plasma of magnesium deficient rats as compared to the untreated animals. The platelet count of the magnesium deficient calves and in the citrated platelet-rich plasma of the magnesium deficient rats was not different from the normal. The thrombin clotting and partial thromboplastin times were significantly shortened in the magnesium deficient calves, but the prothrombin time was not affected. These findings suggest that pathological alterations in the serum magnesium levels that are still compatible with life do not influence adenosine diphosphate-induced platelet aggregation but do affect the breakdown of adenosine diphosphate in the plasma of rats. Just as magnesium administration may produce an anticoagulant effect, so may magnesium depletion produce a procoagulant effect in the blood of animals rendered magnesium deficient by diet. The clinical implications of this are discussed.

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