Platelet-poor plasma

Platelet-Poor Plasma (PPP) is blood plasma with very low number of platelets (< 10 X 103/μL). Traditionally, PPP was recommended for use in platelet aggregation studies to both adjust the Platelet-rich plasma concentration, and to serve as a control.[1] PPP may have elevated levels of fibrinogen, which has the ability to form a fibrin-rich clot once activated. Wound healing requires cell migration and attachment, which is facilitated by this fibrin clot.[2]

Current Uses

Fibrin sealants have found use in many clinical situations such as blood management,[3] orthopaedic surgery,[4] and cosmetic surgery.[5]

Preparation of platelet poor plasma
  1. Within 1 hour of blood collection, centrifuge capped citrate (blue top) tube for 15 minutes
  2. Using a plastic transfer pipet, remove the top 3/4 of plasma and place it in a plastic centrifuge tube with cap.
  3. Centrifuge the plasma (in the plastic centrifuge tube) for another 15 minutes.
  4. Using a plastic transfer pipet, remove the top 3/4 into a plastic tube. Do not disturb the plasma in the bottom of the spun tube, where any residual platelets will be.
  5. Aliquots with visible red cells or hemolysis (pink plasma) are not acceptable.
  6. Freeze plasma immediately. Samples for most laboratory assays should be frozen within 4 hours of collection.

Future possibilities

As a byproduct of PRP preparation, PPP may also find use in tissue engineering applications as an autologous degradable scaffold. This plasma portion is frequently discarded when used with PRP treatments.

Notes
  1. Marco Cattaneo, Anna Lecchi, Maddalena Loredana Zighetti, Federico Lussana. "Platelet aggregation studies: autologous platelet-poor plasma inhibits platelet aggregation when added to platelet-rich plasma to normalize platelet count". Haematologica, 2007, 92(05)
  2. Richard A.F. Clark. "Fibrin and Wound Healing". Annals New York Academy of Sciences, 2001, vol. 936 pp. 355–367.
  3. R.K. Spence. "Current concepts in Blood Management". Orthopaedics, 2004;27:S643-S641
  4. R. Justin Thomas, Scott E. Marwin. "The role of fibrin sealants in orthopaedic surgery". Journal of the American Academy of Orthopaedic Surgeons, 2009, Vol 17, No 12.
  5. Man, D., Plosker, H., Winland-Brown, J.E. "The use of autologous platelet-rich plasma (platelet gel) and autologous platelet poor plasma (fibrin glue) in cosmetic surgery". Plastic and Reconstructive Surgery, Vol 107, Issue 1, pp. 229–239
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