Platelet-rich plasma treatment requires extensive preparation to get right since only the purest PRP samples can reach the activation status needed to trigger the body’s wound healing and cell regrowth response. As a result, the preparation of the PRP solution – in particular, in the processing of the blood that the PRP concentrate will be extracted from. This process is extremely delicate and needs several compounds to make sure the whole-blood samples remain usable throughout the procedure, which is where anticoagulants come in.
So is heparin a good anticoagulant for platelet-rich plasma treatments? The few studies we have on the performance of heparin in PRP treatments seem to indicate otherwise. While it’s a perfectly acceptable anticoagulant to use in any other medical or clinical setting, platelet concentration and platelet quality will almost always dip when it’s used in PRP preparation. For most cases, the FDA-approved anticoagulant citrate dextrose solution (ACD-A or Solution A), is more than enough to act as an acceptable anticoagulant.
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To understand why heparin can underperform as an anticoagulant, it’s crucial to understand the three-step process that defines PRP treatment. While the exact specifics of each step (as well as the equipment used) can vary from provider to provider, these are the general steps that are involved in PRP preparation.
After a patient has confirmed their candidacy for PRP treatments, a sample of their blood is extracted from a venous system (usually the arm, but other limbs can also work) and stored for processing. Because you need a high concentration of platelets in a PRP serum, a fair amount of blood needs to be withdrawn from the patient.
Your own blood is the key ingredient to making sure your PRP treatment will work since it’s where the PRP serum for your treatment will come from. This is one of the main advantages of PRP treatment: since it uses your own blood and own cells in the procedure, there’s less chance of it being rejected by your system – and a higher chance that the effects will come sooner.
Processing is arguably the most difficult and longest part of PRP preparation since this is the stage where the PRP concentrate is extracted from the blood sample. There are different methods of processing that can drastically change the type of PRP serum used in your treatment: some add fibrin to the mix to make a platelet-rich fibrin matrix, while other providers can leave it in the white blood cells to help your body’s immune response after treatment.
The main concern in this step is to make sure that the purest PRP concentrate is extracted from the blood since it’s by platelet counting that your provider can determine how effective your treatment will be. Most of the time, this is achieved by using a specially-designed centrifuge to separate the platelet concentration from white blood cells, red blood cells, and other compounds into its own layer. This layer is further processed into a pure PRP serum, ready to be injected back into your body.
Finally, the PRP serum is injected into the affected area. The number of injections you’ll get will usually be determined by the specific condition you want to treat – for sports injuries and other related concerns, a single injection may be enough to provide you the results that you want. But for people looking for long-term benefits from PRP treatment, they may need several injections spread over a few weeks to a few months.
It’s important to find a provider that can accurately diagnose which part of your body needs the PRP injection since the number of platelets that you can work with per treatment session is limited. While there’s no harm in getting platelets into other areas of your body, it’s far more efficient if your PRP solution is injected directly into the area that needs treatment.
Now that you know the basic steps for PRP preparation, where do anticoagulants come in? Anticoagulants play a crucial role in the processing stage of PRP treatment since the extracted blood is not always processed immediately after it’s been drawn out of a patient.
There could be several reasons for this:
Whatever the case, anticoagulants are necessary to keep the blood in a stable condition so that it can be stored, processed, and turned into a PRP solution. Once the blood starts clotting either by the accidental addition of chemical compounds, mishandling, or temperature changes, there’s very little chance that a workable PRP solution can be extracted from the sample. Given the relative amount of blood needed for a single PRP sample, patients can’t be counted on to keep providing samples if the initial one has been affected.
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While anticoagulants are crucial to the PRP process, not every type of anticoagulant is suitable for the job. Heparin is a well-known anticoagulant that’s used in many medications, surgeries, and other medical procedures – but how it works in keeping the blood from clotting makes it unsuitable for PRP preparation.
Your blood is made up of a few different components, but the major components that are used in most cosmetic and medical applications are your white blood cells, red blood cells, and your platelets. These different types of cells respond to chemicals differently – and not all types of procedures will require all three at the same time.
PRP injections in particular need as much of your platelets as they can get from your blood, which means that red blood cells and white blood cells aren’t needed. Barring some specific types of PRP treatments, an anticoagulant used for PRP preparation only needs to keep the platelets intact.
Heparin, in addition to its blood-thinning properties, closely bonds with all platelets. This can make processing platelets difficult since the filter also needs to remove the heparin component from the platelet layer. Because of the risks of over-processing the blood, heparin isn’t ideal as an anticoagulant for PRP preparation.
Additionally, heparin can also cause thrombocytopenia (low platelet count) under the right conditions, which can drastically affect the amount and quality of the platelets in the final PRP serum. Given all of these risks to a potential sample, experts do not recommend the use of heparin for PRP treatments.
Fortunately, the FDA has already approved a specific anticoagulant for use in platelet-rich-plasma treatments: ACD-A, otherwise known as Anticoagulant Citrate Dextrose Solution or Solution A. It’s a citrate-based anticoagulant, which uses a type of bonding that leaves the platelets relatively unaffected while also keeping the blood from clotting.
ACD-A has been the gold standard of anticoagulants for PRP treatments ever since the PRP injections became more popular in both sports medicine and cosmetic applications. Using ACD-A even helps impair the activation of thrombin while your blood is being processed, which drastically lowers the possibility of any effects on the platelet count of the sample.
Most providers will usually use ACD-A since the resulting PRP sample has a higher platelet concentration compared to other anticoagulants that can be used during the processing stage. Given the current evidence backed by other practices and the FDA, ACD-A remains to be one of the best choices for anticoagulant use in PRP preparation.
One recent study found that ethylenediaminetetraacetic acid (or EDTA) can also be used as an anticoagulant for PRP preparation, though the process for preparing and administering the compound during the processing stage needs to follow more precise steps compared to ACD-A.
Traditionally, EDTA has also been considered in the same category as heparin when it comes to being used as an anticoagulant for PRP preparation. However, with careful administration of the chemical during the processing and injection stages, it’s possible to use EDTA to drastically simplify the processing of platelets and optimize the PRP preparation process overall.
However, it’s also important to keep in mind that this study hasn’t been replicated on a larger scale and is still pending approval from the FDA and other regulatory commissions. For practices that want a simple solution to an anticoagulant for their PRP preparation, using ACD-A is still the best choice.
With all the steps outlined above for the preparation and administration of PRP treatments, it’s not unusual to find practices and patients who may be unwilling to go through all the hassle and prep work required for the treatment. And while PRP treatments work well to help improve the overall state of your body, there are times when the results that you want don’t have to be that drastic.
For instances where you’re only looking to improve your hair density and scalp health, you can consider using PEP Growth Factor products in the place of PRP treatment. Made from a proprietary mix of fibroblast growth factor, copper peptides, and other essential nutrients, PEP growth factor products are easy to integrate with your existing hair care routines.
There are several reasons why PEP growth factor products have become a favorite of many users looking for hair and scalp rejuvenation:
Using PEP growth factor products can improve hair density, promote scalp health, and overall be easier for a person to use compared to PRP therapy. Since it’s a topical product, all you need to do is to apply it consistently, and you may be able to see your results within a few weeks.
The crucial thing to keep in mind is that PEP growth factor products should only be bought from a licensed distributor. This way, you’re sure that you’re getting a PEP product that has the right concentration required to give you the results that you want.
While heparin can work as an acceptable anticoagulant for medical applications like surgery and other medical procedures, its effects on platelets make it unsuitable for regenerative medicine. While there are few studies on the effects of heparin on platelet aggregation, the information that we do have shows that platelet count – and overall platelet volume – can be drastically affected if heparin is used as an anticoagulant. For providers looking for the best anticoagulants to maintain the efficacy of platelet solutions, most findings will indicate using acid citrate dextrose solution A or B, or sodium citrate. However, if providers don’t want to use citrate-based anticoagulants, ethylenediaminetetraacetic acid can also work.
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