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Conclusions Plateltex provided platelet recovery, collection efficiency and PDGFAB availability close to those provided by other systems marketed with the same
intended use. Batroxobin, the enzyme provided to induce gelation, acts differently
from thrombin, which is used by most other systems. Platelets treated with thrombin
become activated; they release their growth factors quickly. Furthermore, thrombin
platelet interaction is a physiological mechanism that hastens the clot-retraction rate.
On the contrary, platelets treated with batroxobin do not become activated; they are
passively entrapped within the fibrin network, and their growth factor release occurs
slowly. In these conditions, the clot retraction takes longer to occur. According to
these differences between thrombin and batroxobin, it is expected that batroxobininduced PRP activation will tailor slow release of the platelet content, thus, providing
longer in loco availability of trophic factors. In selected clinical conditions, this durable
anabolic factor availability might be preferable to quick thrombin-induced growth
factor release.
Key words: batroxobin, platelet gel, platelet-rich plasma.
Correspondence: Laura Mazzucco, Blood Transfusion Centre and Biotechnology Laboratory, Ospedale SS Antonio e Biagio, Via Venezia 16, 15100 Alessandria,
Italy
E-mail: lmazzucco@ospedale.al.it
2 L. Mazzucco et al.
Introduction
Platelet-rich plasma (PRP) represents an emerging biotechnology in current tissue engineering and cellular therapy; it
is likely that platelet gel will be used widely in future for soft
and bony tissue repair [1]. Several devices to produce PRP
and platelet gel have been commercially released for topical
therapy. There is increasing evidence regarding the clinical
use of platelet gel [27]. Somehow more intriguing is the
concern about the equivalence or the differences among the
methods or the devices available to produce the PRP [814].
Prior to clinical use of a new device, its technical performance
must be tested and, if possible, the results should be compared to those of other products with the same intended use.
The aim of this report is to evaluate the efficiency of PRP
preparation using the Plateltex kit (Plateltex, Bratislava,
Slovakia) and to compare the results with those obtained
from other similar devices.
Increasing consent is accumulating that PRP products
must achieve a platelet count of at least 1 109/ml to be in
the therapeutically effective range, indicating approximately
a 45 times the baseline value [1,15,16].
Taking this enrichment as a prerequisite of the study, in
this report the performances of the Plateltex platelet gel
preparation kit have been tested. The technical end-point of
the study were: (i) the platelet yield, (ii) the collection efficiency, (iii) the gelation time, (iv) the concentration of some
platelet-derived growth factors (PDGF). The kinetics of the
gelation and some properties of the gelation-inducing enzyme,
batroxobin, were evaluated as well.
Statistical analysis
The mean and the standard deviation were determined when
relevant to evaluation of the end-points of the study. To
Table 1 Volume, platelet count, yield and collection efficiency after platelet-rich plasma (PRP) sequestration obtained through soft-spin centrifugation of the
whole blood performed according to the manufacturers directions. The volume of the concentrated platelets following high-speed centrifugation (desired final
concentration 2 109/ml) and that of the platelet-poor plasma are reported in the last two columns (right)
Whole blood
PRP
Volume (ml)
Donor
ml
l 103
Platelet/
Platelet
absolute 109
ml
l 103
Platelet/
Platelet
yield 109
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Mean
SD
16
16
16
16
16
16
16
16
16
16
16
16
16
16
16
16
16
16
16
16
188
176
234
254
192
207
321
198
222
284
310
254
262
266
170
327
231
325
256
244
30
28
37
41
31
33
51
32
36
45
50
41
42
43
27
52
37
52
41
39
90
80
83
100
96
104
94
94
106
98
94
86
84
80
102
94
94
96
86
86
256
288
319
368
278
288
452
265
272
333
458
341
365
395
214
454
320
456
356
296
23
23
26
37
27
60
42
25
29
33
43
29
31
32
22
43
30
44
31
25
Collection
efficiency
(%)
2 109
platelet/ml
Harvested
PPP
77
82
71
91
87
90
83
79
81
72
87
72
73
74
80
82
81
84
75
65
79
68
12
12
13
18
13
15
21
13
14
16
22
15
15
16
11
21
15
22
15
13
16
034
78
68
70
82
83
89
73
81
92
82
72
71
69
64
83
73
79
74
71
73
76
073
Results
The amount and the platelet concentration of the PRPs
harvested from each blood sample are reported in Table 1.
The mean collection efficiency was 79 68% (range 6591%).
The final volume of the recovered hyperconcentrated platelets
(2 109/l) and the amount of the platelet-poor plasma
harvested after the high-spin centrifugation are also reported.
The kinetics of the gelation was evaluated by light transmission analysis. The results are given in Fig. 1. Figure 1
depicts the increasing turbidity of the PRP solution after the
addition of (i) calcium gluconate, (ii) batroxobin, or (iii) a
combination of both according to the Plateltex instructions.
4 L. Mazzucco et al.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Mean
SD
Fibrinogen
(mg/ml)
Starting (second)
231
293
287
139
278
183
244
181
139
183
264
415
268
156
183
224
307
263
577
256
254
1012
58
70
113
115
128
59
60
65
60
70
75
55
60
65
60
120
100
90
80
55
78
241
7
75
75
9
9
10
85
6
75
8
75
65
7
8
85
10
85
95
95
75
81
11
Table 3 Benchmark comparison of the mean platelet recovery and of the mean platelet-derived growth factor AB (PDGF-AB) content
PRGF kit
PRP (Landesberg)
AG Curasan
PCCS
Harvest
Vivostat
Regen Kit
Fibrinet
Plateltex
PDGF-AB (ng/ml)
Activator
20
60
15
50
50
120
10
8
8
95 41
106 24
76 16
85 35
100 0
50 0
50 05
44 02
50 04
35 16
30 10
33 10
68 9
67 10
17 6
90 5
65 10
79 7
47 21
33 7
35 17
103 27
133 29
130 29
140 14
105 30
60 20
Autologous thrombin
Ca++, thrombin
Ca++, thrombin
Ca++, thrombin
Ca++, thrombin
Neutralization of acidified batroxobin
Autologous thrombin
Ca++, high speed centrifugation
Ca++, batroxobin
6 L. Mazzucco et al.
Acknowledgements
The authors are indebted with Dr Michael Ellard for his kind
revision of the manuscript.
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