Principle: | Personnel: | Specimen: | Materials: | Reagents: N.A. | Standardization: N.A. | Procedure: | Limitations: | Result Derivation: | Expected Result(s) | Quality Control: | References:
This test is performed as a definitive function to monitor the efficacy of Platelet Rich Plasma (PRP) sequestration, and its resultant elevated platelet count, from an autologous blood sample drawn at the point of care. Studies have shown that the application of platelet rich plasma provides a concentrated source of platelet-derived growth factors, which stimulate and enhance the healing response. PRP is used in select open heart, spinal, orthopedic and plastic surgery procedures.
It is expected to achieve concentrated platelet counts in excess of three to five times the baseline count. Platelet viability is an important factor toward this outcome.
This test should be performed on a periodic basis.
1. The Surgeon orders and applies the PRP during the surgical procedure.
2. The Perfusionist obtains the autologous whole blood required for PRP sequestration and provides the baseline and PRP platelet count samples for laboratory analysis.
3. The Laboratory Technologist runs the baseline and PRP platelet counts.
The first specimen, 0.5 ml heparin whole blood, is analyzed to determine the baseline platelet count. The second specimen, 0.5 ml PRP (anticoagulated with ACD) is analyzed to determine the concentrated platelet count.
1. DePuy Symphony Platelet Concentrate System
B. Blood draw
C. Processing components
2. 3cc ABG syringe (Marquest #021-7003487-03)
1. At the start of the surgical procedure, the Perfusionist will deliver 0.5 ml of whole blood to the lab for a baseline platelet count.
2. A patient whole blood sample of 60 ml will be processed according to the Platelet Rich Plasma procedure. After the whole blood has been centrifuged and PRP has been sequestered, the Perfusionist will deliver 0.5 ml of PRP to lab for a platelet count on the concentrated sample.
3. The baseline and concentrated platelet level reports will be stored in the Perfusion Office.
1. Patients should be off aspirin therapy for 48 hours prior to surgical procedure.
2. Pre-op heparin therapy is contraindicated because it may cause platelet activation and aggregation. Heparin therapy may cause heparin-induced thrombocytopenia, with a resultant low platelet count. Low molecular weight heparin does not affect the platelets.
3. There is no contraindication for coumadin therapy.
LH750 Platelet Count reports will be printed and given to the Perfusionist.
Platelet Counts on concentrated samples will typically be three to five times the baseline platelet count. This may vary with different patients. Concentrate is considered acceptable as long as the platelet count on the concentrate is higher than the baseline.
1. If the Platelet Count on the concentrated sample is not three times higher than baseline on a check, the check will be repeated on the next available patient sample.
2. If lower than expected recovery on concentrated specimens occurs on two checks in a row, the manufacturer will be contacted to function check the equipment and operator technique will be reviewed.
1. Kevy, SV, et al. Quantitative and Qualitative analysis of Autologous Platelet Products.
i. April 2007 R. Beecher, Perfusionist
January 2011 L. McGovern (no changes)
January 2012 R. Beecher/L. McGovern (Revised: III.)
February 2012 R. Beecher/L. McGovern (Revised: frequency)