Table 2.
Components of Platelet-Rich Plasma Preparation in 36 Included Studies
| Author, Year | Platelets | |||||||
|---|---|---|---|---|---|---|---|---|
| The Method of PRP Preparation | The Volume Injected per Session | Frequency of PRP | Interval of PRP Administration | Platelet Count | Leukocyte Content | Red Blood Cell Content | Activation Yes/No | |
| Lee 201850 | Eight mL of blood was drawn from the antecubital vein. Blood was collected in 3 tubes containing 7.2 mg of EDTA each. Samples were centrifuged at 3200 rpm for 5 minutes, following which 2 layers were formed over the parser gel and a bottom layer of erythrocytes, a middle layer containing the buffy coat of PRP, and a top layer of PPP. The yellow fluid of PPP was gently collected using a syringe and set aside. The buffy coat was then collected and combined with enough PPP to produce 4 mL of PRP. | 0.33 mL at each site (2 mL total) | 1 | – | – | – | – | No |
| Cameli 201751 | Nine mL of venous blood was collected in a sterile kit from each patient. Blood tubes were immediately processed by centrifugation for 8 minutes at 1100 rpm. The PRP obtained remained for 30 to 45 minutes at room temperature to dissolve the platelet aggregates before splitting into 4 one milliliters aliquots. | 4 (1 mL into forehead and crow’s feet area; 2 mL into the cheeks [1mL per side]; and 1 mL into the nasolabial folds) | 3 | 3 sessions of treatment at 1-month intervals | 885–3760 × 106/mL (mean: 1680 × 106/mL) | 0.03 × 10/µL-7.6 × 10/µL, (range 1.9) | - | No |
| Abuaf 201652 | Eight mL blood sample was aspirated from the patient’s peripheral vein in tubes containing sodium citrate anticoagulant. The test tube was centrifuged at 3000 rpm during 5 minutes. Red blood cells were discarded from the plasma at the bottom of the gel. Platelets and white blood cells were pellet on top of the gel and re-suspended in plasma by gently mixing the tube. The 2 mL of cell suspension was called the PRP | 2 mL | 1 | - | - | - | - | - |
| Elnehrawy 201753 | Eighteen milliliters of subject blood was collected into special vacuum tubes pre-equipped with sodium citrate solution as an anticoagulant followed by centrifugation for 7 min at 388 g resulting in a yellow upper part of plasma and a lower red part of erythrocytes. The plasma part was aspirated and placed in another vacuum tube to be centrifuged for the second time at 1376g for 5 min. PPP was first gently aspirated to avoid its mixing with the lower part and the PRP (the residual part) was subsequently aspirated and prepared for activation. | - | 1 | - | - | - | - | Yes |
| Gordon 201654 | Blood was drawn from the cubital fossa area. An amount of 32 mL was harvested and centrifuged at 450 g for 9 minutes using the BTI Endoret system. Visual manual separation of PRP was carried out. The PPP was separated out to be prepped for topical placement. The PRP was extracted and activated with calcium chloride for injection and topical injection. | 0.1 mL at each site | 2 | 2 sessions of treatment at 4-week intervals | - | - | - | Yes |
| Yuksel 201444 | Eight mL of blood was collected from each volunteer. The tube with cell extraction kit and ficoll was centrifuged at 3200 rpm for 8 min following which two layers were formed over the parser gel and erythrocytes remained under it. PPP was the yellow fluid at the top of the tube and collected using a syringe. PRP was the buffy coat over the parser gel and withdrawn with a long cannula. | - | 3 | 2-week intervals | - | - | - | - |
| Mehryan 201455 | Ten mL of each participant’s venous blood was drawn and emptied into 10-mL tubes and centrifuged 1600–1800 g /6 min. A second cycle of centrifugation was performed using 2000 g for 5 min. Then, the bottom 3 milliliters of plasma in the upper chamber was taken out gently. After that, the extracted PRP was transferred into 1-mL insulin syringes and activated by adding 0.1 mL of calcium chloride to 0.9 mL of PRP. | 1.5 mL | 1 | - | - | - | - | Yes |
| Kang 201456 | Twelve mL of blood and the MyCells® kit were used for PRP preparation. PPP was carefully aspirated from the supernatant fluid. A total volume of 1 mL of PRP was finally concentrated. | 1 mL | 1 | 3 treatment sessions at 4-week intervals | - | - | - | No |
| Redaelli 201057 | - | 4 mL | 3 | 3 treatment sessions at 1-month intervals | - | - | - | Yes |
| Ibrahim 201813 | Ten mL of autologous whole blood was collected into tubes containing acid citrate dextrose and centrifuged at 2500 rpm for 10. Then, the PRP was further centrifuged at 3500 rpm for 10 min at room temperature to obtain a platelet rich count. PPP was partly removed and partly used to resuspend the platelets and activated using calcium gluconate. | 0.1 mL at each site | 6 (maximum 6 or till patient satisfaction) | 3-week intervals | - | - | - | Yes |
| Min 201815 | Ten mL of venous blood was drawn in a syringe prefilled with 1.5 mL of anticoagulant solution. The blood was centrifuged at 160 g for 10 minutes. After the first spin, the lower red blood cell portion was discarded, and the supernatant was centrifuged at 400 g for 10 minutes. The resulting pellet of platelets was mixed with 1.5 mL of supernatant, which made 1.5 mL of PRP. | 0.02 mL at each site | 2 | 4-week intervals | - | - | - | Yes |
| Abdel Aal 201816 | Ten mL of blood was collected in special five sterile vacutainer tubes containing an anticoagulant Na Citrate 3.8%. Each tube was centrifuged at 3000 rpm for 7 minutes at room temperature in order to separate red blood cells from plasma, which contains “buffy coat” (white blood cells and platelets). The plasma and buffy coat were gently aspirated from each tube and transferred to a second tube (plain tube without anticoagulant). Further centrifugation was carried out at 4000 rpm for 5 minutes at room temperature, thus obtaining a two-part plasma: the uppermost part, consisting of PPP, and the lower part, consisting of PRP. | 0.1 mL at each site | 2 | 3 to 4-week intervals | - | - | - | Yes |
| El-Domyati 201711 | Ten milliliters of blood was drawn from each patient into conical tubes and centrifuged at 252 g for 10 minutes (1st spin). Precipitation of RBCs occurred at the bottom of the tube and the plasma-containing platelets at the rest of the tube. The plasma was gently transferred to an empty tube and centrifuged again at a higher spin at 1792 g for 5 minutes (2nd spin) to precipitate the platelets at the bottom of the tube, after which sample was divided into 2 parts; the PRP (the lower one-third) and the PPP (the remaining upper portion). | - | 6 | 2-week intervals | - | - | - | Yes |
| Al Taweel 201821 | Fifteen mL of autologous blood was withdrawn from each patient into tube containing 4% sodium citrate. The tubes were centrifuged at 1500 rpm for 6 minutes at room temperature resulting in three basic components, red blood cells (bottom of the tube), PRP (middle of the tube), and PPP (top of the tube). Separated PRP with PPP was collected with the help of pipette in another test tube. This tube was rotated in a second centrifugation at 2500 rpm for 15 minutes. The upper layer containing PPP was discarded, and the lower layer of PRP was loaded in an insulin syringe. | - | 3 | 1-month intervals | - | - | - | - |
| Tenna 201725 | The production of PRP was achieved by the RegenLab THT tube® method. | - | 2 | 6 months | - | - | - | - |
| Asif 201612 | Seventeen milliliters of blood was withdrawn in a 20-mL syringe prefilled with 3 mL of acid-citrate-dextrose anticoagulant. First centrifugation was performed at 293.88 g for 5 min (soft spin). Both buffy coat and plasma layer were taken for further centrifugation and red cell sediments were discarded. Second centrifugation was performed at 690.94 g for 17 min (hard spin) resulting in the formation of PPP above and platelet-rich zone at the bottom, then the PPP was removed and discarded leaving behind a solution of 2 mL PRP. | 2 mL | 3 | 1-month intervals | 1173 × 107 platelets/mL | - | - | Yes |
| Faghihi 201617 | Twenty mL of blood was drawn from the participant’s medial cubital vein and transferred to a tube prefilled with 2.4 mL anticoagulant (citrate phosphate dextrose) solution. The mixture was then centrifuged at 2000 g for 3 min. After the first spin, the lower red blood cell portion was discarded and the supernatant that contained PPP and buffy coat was centrifuged at 5000 g for 5 min. The resulting pellet of platelets (lower portion) was mixed with 4 mL of supernatant. | 0.2 mL at each site | 2 | 1-month intervals | - | - | - | Yes |
| Sevilla 201558 | Acid citrate dextrose vacutainer containing whole blood was centrifuged at 380 g for 15 minutes. The upper layer of plasma was removed in another sterile centrifuge tube leaving behind buffy coat in the middle and packed red blood cells at the bottom. PRP was centrifuged again at 2700 g for 10 minutes. Supernatant containing PPP was then removed and collected in other sterile centrifuge tube for subsequent use. Platelet-rich pellet at the bottom was then suspended in 5 mL of plasma to make platelet-rich suspension. | 2.5 mL | 1 | - | 625 × 106/mL | - | - | - |
| Zhu 201322 | Ten mL of blood was drawn from the participant’s medial cubital vein and collected in a sterile tube containing 1 mL anticoagulant. After measuring the blood platelet concentration, the tubes were centrifuged at 1500 rpm for 10 min. The first spin separated PPP from RBCs and PRP. The PPP, PRP and a few RBCs were aspirated into a new tube, mixed, platelet concentration was detected again, and in the second spin, the tubes were centrifuged at 3000 rpm for 20 min. The upper section consisted of PPP and the PRP collected at the bottom of the tube. | - | 2 | - | 700–1000 × 106/mL | - | - | Yes |
| Lee 201118 | Sixty mL of blood was drawn from the participant’s medial cubital vein. Blood was aliquoted into the anticoagulant over a period of 10 seconds. The anticoagulated blood was then gently pipetted into the separation kit to minimize red blood cell damage. The mixture was then centrifuged at a speed of 3000 rpm for 3 minutes. The blood was separated into PPP, buffy coat, and RBCs. Because PRP is a mixture of buffy coat and plasma, RBCs were extracted from the kit. For further concentration, the separated fraction composed of PPP and buffy coat was centrifuged with the concentration kit for 3 minutes at 4000 rpm. | 0.3 mL per site | 2 | 1-month interval | - | - | - | - |
| El-Domyati 201810 | Ten milliliters of blood was drawn from each patient under sterile condition, collected, and put into conical tubes that contained 2 mL acid citrate dextrose solution, then, the tube was centrifuged at 252 g for 10 minutes (first spin). Precipitation of RBCs happened at the bottom of the tube and the plasma containing platelets at the rest of the tube. The plasma was gently transferred to an empty tube and then re-centrifuged at a higher spin of 1792 g for 5 minutes (second spin) to precipitate the platelets at the bottom of the tube. After the second spin, the sample was divided into two parts; the PRP (the lower one-third) and the PPP (the remaining upper portion). | - | 6 | 2-week intervals | - | - | - | Yes |
| Deshmukh 201839 | Twenty milliliter of blood was withdrawn and initially centrifuged at 800 rpm for 8 minutes (slow spin). The separated plasma was collected along with superficial layer of RBCs and centrifuged again at 1200 rpm for 12 minutes [heavy spin] to obtain a small pellet of platelet concentrate. Upper 2/3rd plasma was collected as PPP, and the bottom pellet was resuspended in the residual lower 1/3rd plasma and used as PRP. | 1.5 to 3 mL | 4 | 4-week intervals | - | - | - | Yes |
| Kar 201720 | Whole blood samples (10 mL) were drawn from patient’s medial cubital vein and transferred to a vial containing an anticoagulant. It was centrifuged at 1500 rpm for 10 min. PPP, PRP, and a few RBCs were aspirated into a new tube and centrifuged at 3000 rpm for 20 min. The middle layer that consists of the PRP was aspirated for topical application. | - | 3 | - | - | - | - | - |
| Willemsen 2018 | - | 3 mL | 1 | - | - | - | - | - |
| Ali 2018 | - | - | 7 | 1-month intervals | - | - | - | - |
| Ibrahim 20179 | Ten to 20 cc of venous blood was collected from the antecubital vein. The whole blood sample was collected into tubes containing sodium citrate (10:1) as an anticoagulant. Then, the citrated whole blood was subjected to two centrifugation steps. The initial centrifugation (“soft” spin) at 1419 g for 7 minutes to separate the plasma and platelets from the red and white cells. The resulting plasma supernatant, which contains the suspended platelets was harvested to a second centrifugation step (“hard” spin) at 2522 g for 5 minutes, leading to separation of the plasma into two portions: PPP and PRP. | 0.1 mL per site | 6 | - | - | - | - | Yes |
| Ulusal 201735 | About 12.5 cc of patients’ blood was collected in a syringe. Then, whole blood was instilled to a PRP kit and centrifuged at 1800 rpm for 20–50 min until all RBCs separate from plasma and the buffy coat became clearly visible. The buffy coat (PRP and PPP) were collected in 5 cc syringes. | - | 11.7% = 1, 20.2% = 2, 31.9% = 3, 5.31% = 4, 12.7% = 5, 7.44% = 6, 2.12% = 7, 8.51% = 8, Mean = 3.6±2 | 3 to 4-week intervals | - | - | - | No |
| Hui 201719 | About 30 mL venous blood were drawn in a sterile syringe containing 600 U heparin calcium. The blood sample was centrifuged at 1200 rpm for 10 minutes. Subsequently, plasma, buffy coat, and 2–3 mm RBCs were collected, mixed, and then centrifuged at 3500 rpm for 5 minutes. About 1/2 volume of PPP was discarded, and the remaining PPP was resuspended to obtain PRP. | 0.1 mL per site (2.2 mL total) | 3 | 3-month intervals | 700–1000 × 106/mL | - | - | Yes |
| Kamakura 201536 | Nine mL of blood was collected and in the first round, centrifugation was performed at 1800 rpm for 10 minutes, after which the top layer of plasma was collected. In the second round, centrifugation was performed at 3200 rpm for 10 minutes, after which the buffy coat and bottom layer of plasma were collected. | Varies with every patient | 1 | - | - | - | - | - |
| Willemsen 201427 | - | 3 mL (1.7 mL each side) | 1 | - | - | - | - | Yes |
| van Dongen 202159 | Prior to the surgery, 62 mL of whole blood was drawn from each subject and 8 mL of anticoagulant citrate dextrose solution A was added to 52 mL of whole blood and prepared following the Arthrex Angel system™ instructions. This resulted in 6 mL of non-activated PRP with a platelet concentration of 4 times the baseline. | Varies with each patient | - | - | - | - | - | Yes |
| Abdel-Maguid 202137 | - | Not mentioned (venous blood 10 mL taken) | 12 sessions (at 2 weeks interval) | 2 weeks interval | 200,000 ± 500,000 cells/mL | - | - | Yes |
| Sasaki 201930 | Fifty-four mL of whole blood was withdrawn from an antecubital arm vein mixing with 6 mL of adenosine-citrate-dextrose. Through floating shelf and double spin centrifuge technology, PPP was used to resuspend the buffy-coat pellet to a final volume suspension of approximately 7 mL PRP. | 7 mL (Final concentration: 6 mL) | 3, 6- and 12-month sessions | - | 1.214 ± 3.9 × 106/µL | - | - | Yes |
| El-Taieb 201923 | Ten mL of blood was obtained and collected in sterile tubes containing sodium citrate 3.8%. Each tube was centrifuged at 2000 rpm for 7 min. The plasma and buffy coat were gently aspirated from each tube and transferred to another tube (plain tube without anticoagulant). Further centrifugation was carried out at 4000 rpm for 7–10 min, thus obtaining a two-part plasma: an uppermost part consisting PPP, and a lower part consisting of PRP. | Not mentioned | - | - | - | - | ||
| Rigotti 201628 | Peripheral blood was collected using blood collection tubes containing 0.5 mL 3.2% sodium citrate solution. Whole blood was centrifuged at 300 g for 5 minutes. After the first centrifugation, the whole plasma above the buffy coat was collected, separating platelets from RBCs and leukocytes (PRP1). PRP1 was centrifuged at 700 g during 17 minutes, after which the platelet pellet was suspended in 300 μL of PPP (new fraction named PRP2). | - | - | - | - | - | - | Yes |
| Alam 201814 | The blood sample was combined with acid citrate dextrose A, and spun in a centrifuge with 2 spins (a hard spin and a soft spin) to separate the PRP from PPP. The remaining PRP was then injected into the cheek of the participant within the next 7 minutes. | 0.1 mL per site | 12 months | - | - | - | - | Yes |
Abbreviations: EDTA, ethylenediamine tetraacetic acid; g, gravitational forces; rpm, revolutions per minutes; PPP, platelet-poor plasma; PRP, platelet-rich plasma; RBCs, red blood cells.