TMSS Medical College Journal

Background: Platelet-rich plasma (PRP) effectiveness depends on platelet concentration, centrifugation geometry, and anticoagulant choice. Internal protocols favor swing-bucket centrifuges and ACD-A anticoagulant due to superior platelet recovery, but in Bangladesh fixed-angle centrifuges and sodium citrate are widely used because of affordability and availability. This study compared PRP yield between these two locally adopted and internationally recommended techniques. Materials and Methods: This analytical laboratory-based study was conducted between March and May 2025 in selected government and private hospital laboratories in Bangladesh. Eighty PRP samples were prepared using fixed-angle or swing-bucket centrifuges with either sodium citrate (3.2%) or ACD-A as anticoagulant (20 samples per group). Baseline platelet count, PRP platelet count, platelet concentration factor (PCF), WBC content, and RBC contamination were assessed. Analysis included two-way ANOVA, independent t-tests, and multivariable regression. Results: Swing-bucket centrifuges produced significantly higher PRP platelet counts (818–950 ×109/L) than fixed-angle centrifuges (573–667 ×109/L) (p<0.001). ACD-A yielded higher PCF values than citrate (p<0.001). ANOVA showed significant effects of centrifuge type and anticoagulant (p<0.001 each), with no interaction. Regression demonstrated that baseline platelet count, centrifuge type, and anticoagulant independently predicted PRP yield (adjusted R²=0.82). Swing groups also showed lower WBC contamination. Conclusion: The centrifugation and anticoagulant methods commonly used in Bangladesh significantly underperform compared with international standards. Adoption of swing-bucket centrifuges or optimized fixed-angle protocols, along with broader use of ACD-A, may substantially improve PRP quality in low-resource settings.

Platletrich plasma (PRP) is increasingly. uilized across orthopedics, sports medicine, wound healing, and dermatology because of ts high concentration of autologous growth factors that stimulate tisue repair. PRP quality is highly dependent on preparation technique, including centrifuge type, spin force, and anticoagulant selection. Intemational standards recommend the use of swing-bucket centrifugation, as the horizontal rotor orientation enables more efficient separation of erythrocytes, leukocytes, and platelets during both soft and hard spins. Conversely, fixed-angle centrifuges, widely used in Bangladesh due to lower cost and greater availability, subject platelets to angular displacement and wall-adherence effects that reduce overall yield and may partially activate platelets prematurely. Similarly, ACD-A anticoagulant, with superior calcium chelation and pH buffering, preserves platelet morphology and viability better than sodium citrate." However, in Bangladesh like many low- and middle-income countries- PRP preparation commonly. uses fixed-angle centrifuges and sodium citrate (32%), creating an evidence gap on how these adaptations affect final PRP quality." The primary objective of this study was to systematically compare platelet recovery, platelet concentration factor, and cellular composition of PRP prepared using centrifugation and anticoagulant methods commonly practiced in Bangladesh with those recommended intemationally. We hypothesized that differences in centrifuge geometry and anticoagulant selection would independently influence PRP yield and quality, even when preparation is performed under routine. laboratory conditions in resource-Jimited settings.