The Effects of Platelet Rish Plasmapheresis in Total Hip Replacement Surgery on Platelet Activation Studied by Flow Cytometry
(English)Manuscript (preprint) (Other academic)
Background: Autologous platelet rich plasma (PRP) harvest with autotransfusion devices has been used for ten years in cardiac surgery and recently in orthopedics. Its influence on the outcome of surgery is still controversial, in part because of methodological difficulties in studying platelet function during surgery.
Methods: Twenty patients undergoing primary total hip replacement (THR) were studied. Ten patients underwent an immediately preoperative platelet apheresis forming concentrated platelet rich plasma (c-PRP). Ten patients not undergoing apheresis were allocated to a control group. Platelet activation was evaluated as the population expressing P-Selektin on the surface of platelets in the c-PRP and in blood samples collected pre-, per- and postoperatively. The method used was flow cytometry.
Results and Conclusions: There is a minor population of activated platelets circulating in the patient's blood with a highly significant difference between patients (p=0.005) with a range of 1-23 % in peroperative activation. PRP harvest did not significantly alter platelet activity. The platelet apheresis procedure did not inhibit platelet function in the c-PRP as judged by a high proportion of platelets that could be activated in ADP stimulation experiments (mean value±SD 86%±7.5%).
The total number of platelets that could be activated in the c-PRP estimated as % ADP activated platelets x % sampled platelets in the c-PRP (total platelet yield), was non significantly correlated (r=-0.59, p<0.l) with postoperative bleeding, indicating a possible hemostatic effect of these platelets.
Autotransfusion, PRP harvest, platelet, flow cytometry, P-Selektin, ADP, bleeding
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-79961OAI: oai:DiVA.org:liu-79961DiVA: diva2:544835