Abstract

Autologous Platelet Gel: An In Vitro Analysis of Platelet-Rich Plasma Using Multiple Cycles

^* Department of Perfusion, Intensive Medical Services of Siouxland, Mercy Medical Center, Sioux City, Iowa
^† Department of Anesthesia, Intensive Medical Services of Siouxland, Mercy Medical Center, Sioux City, Iowa
^‡ Department of Cardiothoracic Surgery, Mercy Medical Center, Sioux City, Iowa
^§ University of Nebraska Medical Center, Clinical Perfusion Education Graduate Degree Completion Program, Omaha, Nebraska

Address correspondence to: Kevin Christensen, c/o UNMC Clinical Per-fusion Education, 985155 Nebraska Medical Center, Omaha, NE 681955155. E-mail: kkc@cableone.net

Abstract

Autologous platelet gel (APG) has become an expanding field for perfusionists. By mixing platelet-rich plasma (PRP) with thrombin and calcium, platelet gel is prepared and used in many surgical settings. There are many devices used to produce PRP. This study evaluates the Medtronic Magellan Autologous Platelet Separator. The purpose of this study was to show that processing two cycles of the same syringe could reduce the amount of blood required to produce a specific volume of PRP. Three 60-mL syringes of whole blood with anticoagulant were removed from 15 elective coronary artery bypass patients. Each syringe produced 9 mL of PRP and 1 mL was sent to the laboratory for analysis. The remaining whole blood in each syringe was processed a second time with a yield of 5 mL of PRP with 1 mL sent to the laboratory. With this data, the Magellan was assessed in three phases. The first phase focused on the consistency of the Magellan. Laboratory values of hematocrit, platelet count, white blood cell count, and fibrinogen were compared between each syringe processed by the device. The second phase dealt with the percentage of platelets in the PRP that the Magellan was able to capture. Finally, results of both cycles were combined and compared against baseline values. Most of the hematological factors evaluated between each syringe were consistent in both cycles. The Magellan was able to capture nearly 70% of all platelets in the PRP of the first cycle and 18.5% in the second cycle. By mathematically combining both cycles, platelet counts averaged 2.8 times baseline with a 3.3 times baseline increase when the volume of the two cycles was weighted. This weighted average was done to reflect a higher concentration of Cycle 1 platelets than Cycle 2 in each sample. This study proved that processing each syringe of whole blood twice could reduce blood requirements while maintaining an effective platelet yield and volume. It also showed that the Magellan does conform to benchmark testing done at Medtronic.