This invention relates to a platelet concentrating system and, more particularly, to a system and method for producing platelet rich plasma (PRP) to be used in medical applications. The system and method increase the concentration of platelets and reduce the level of red blood cells in the PRP.
Platelet-rich blood plasma, commonly known as PRP, is widely used in a variety of medical procedures. The worldwide demand for this blood product is ever increasing. PRP exhibits particularly effective growth-promoting features, which are particularly beneficial in medical applications such as wound care, bone regeneration, maxiofacial surgery and dental care. Platelet rich plasma is most effective when it utilizes a high concentration of blood platelets.
Various conventional devices and processes are available for separating a whole blood sample into its constituent parts (i.e. plasma, red blood cells and platelets). Conventionally, the blood sample is centrifuged and the platelets, combined with white blood cells in the form of a whitish buffy coat, are separated from the blood sample and sequestered in concentrated form though aspiration. Traditional, aspiration techniques often failed to provide a satisfactory concentration of platelets for achieving optimal medical benefits. In addition, cross contamination between the constituent blood components was frequently encountered.
Recently, I have jointly invented and developed products which have significantly improved platelet concentration while reducing cross contamination of blood constituents. See U.S. Pat. Nos. 6,835,353 and 7,976,796. These products have facilitated and improved the process of manufacturing high quality, concentrated platelet rich plasma. Nonetheless, excessive levels of red blood cells commonly remain in much of the PRP currently produced. To date, the PRP industry has experienced difficulty obtaining red blood cell concentrations of less than 15% using conventional processing techniques. It would be both medically and economically desirable to reduce red blood cells while increasing platelet concentrations and purity in processed PRP. The platelet rich buffy coat produced by conventional PRP processing techniques typically contains a significant amount of contaminating red blood cells, even after the blood sample has been separated into its constituent parts.
A further problem accompanying the standard manner of producing PRP involves the anticoagulant that is used. An anticoagulant in the form of ACDA is typically added to the processed blood product in order to restrict clotting and allow the product to be effectively separated into its constituent components. Although ACDA is a fairly effective anticoagulant, it is quite acidic and tends to cause painful side effects for the patient being treated by the manufactured PRP. A great need exists for the use of a different anticoagulant in the production of PRP, which will work at least as efficiently as ACDA, but with less painful side effects.
It is therefore an object of the present invention to provide a platelet concentrating system and related method that enable platelet concentrated PRP to be manufactured more effectively and efficiently than has heretofore been achieved using known technology.
It is a further object of this invention to provide a system and technique for removing more red blood cells from platelet rich plasma so that a more highly concentrated and medically effective PRP product is achieved.
It is a further object of this invention to provide a platelet concentrating system that utilizes commercially available PRP processing equipment in a unique and efficient manner and does not require the development or purchase of complicated, expensive untested and/or experimental technology.
It is a further object of this invention to provide a platelet concentrating system and related method which enable the manufacture of improved, highly concentrated PRP in a relatively uncomplicated, quick, efficient, safe and effective manner.
It is a further object of this invention to provide a platelet concentrating system and related method which employ an anticoagulant that is at least as effective and far less painful than conventional anticoagulants conventionally used to produce platelet-rich plasma.
This invention results from a realization that a high quality, medically effective platelet rich plasma with an increased concentration of platelets may be obtained by processing a patient's blood in multiple stages using the centrifuge tube disclosed in U.S. Pat. No. 7,976,796 (hereinafter Patent No. '796) and a second centrifuge tube featuring two aspiration ports, either as disclosed herein or as disclosed in U.S. Pat. No. 8,835,353 (hereinafter Patent No. '353). The process also employs conventional items such as aspirating syringes and a centrifuge machine. This invention also results from a realization that sodium citrate is especially effective to use as an anticoagulant in the production of PRP. Sodium citrate is less acidic than ACDA, which is conventionally used in PRP manufacture, and therefore causes less painful side effects in patients treated with platelet rich plasma. To date, ACDA has been universally utilized in PRP production because of ACDA's high dextrose content, which allows the PRP to be stored for extended periods. However, PRP is usually manufactured and used at the point of care and thus does not require extended storage. Sodium citrate, which lacks the dextrose content of ACDA, can therefore be used as an effective and far less painful substitute.
This invention features a platelet concentration system and a related method for producing platelet rich plasma (PRP) having a reduced level of red blood cells and an increased platelet concentration. A first preparation centrifuge tube and a second concentrating centrifuge tube are provided. The preparation tube includes an elongate receptacle having an interior chamber for receiving a blood product therein. The receptacle has closed upper and lower ends and a side wall extending between the upper and lower ends. A common inlet and outlet port is formed in the upper end of the receptacle and a flexible, fluid conducting pipe is communicably connected to the common port for extending through the chamber. A liquid-impermeable sealing diaphragm is mounted for sliding longitudinally through the chamber of the receptacle and maintaining sealing interengagement with an interior surface of the side wall of the receptacle. The flexible pipe is disposed through the diaphragm in communication with the region of the chamber located below the diaphragm. The concentrating tube includes a receptacle having an interior chamber, which receptacle has closed upper and lower ends and a side wall extending between the upper and lower ends. Plasma and PRP aspiration ports are formed in the receptacle proximate the upper end of the receptacle. The plasma aspiration port has an aspiration pipe attached communicably thereto and extending through the interior chamber of the receptacle.
To perform the process of this invention, a whole blood sample is drawn from a patient and mixed with an anticoagulant to provide an anticoagulated blood mixture. The anticoagulated blood mixture is introduced into the preparation tube through the common port and flexible pipe such that the mixture enters the chamber of the preparation tube below the diaphragm to drive the diaphragm upwardly within the chamber. The preparation tube is then centrifuged at a speed and duration that separates that anticoagulated whole blood sample into discrete upper and lower fluid layers in the chamber of the preparation tube receptacle. The upper layer includes primarily a platelet plasma suspension that retains at least 30% of the platelets from the blood sample. The lower layer includes primarily red blood cells. The upper fluid layer is aspirated from the interior chamber of the preparation tube receptacle through the flexible pipe and the common port and is then introduced into the interior chamber in the receptacle of the concentrating tube through the plasma port of the concentrating tube. The concentrating tube is then centrifuged at a speed and duration that separates the platelet plasma suspension into discrete top and bottom layers in the chamber of the concentrating tube receptacle. The top layer includes a platelet poor plasma retaining less than 50% of the platelets from the platelet plasma suspension and the bottom layer includes a platelet rich plasma in the form of a whitish buffy coat retaining more than 50% of the platelets from the platelet plasma suspension. The second centrifuging step strips additional red blood cells from the platelet plasma suspension and deposits those red blood cells into the top layer platelet poor plasma. The aspiration pipe attached to and extending downwardly from the plasma port of the concentrating tube is positioned such that its lower end is located within the top fluid layer and above the platelet concentrated buffy coat layer. The platelet poor plasma is next aspirated from the concentrating tube receptacle through the aspirating pipe and attached second port. The concentrating tube is then gently agitated, such as by swirling or otherwise, to resuspend the platelets remaining in the bottom fluid layer into the remaining plasma. Plasma may be added to the concentrating tube through the plasma port to obtain additional volume if required. Finally, the concentrating tube is inverted and the highly concentrated PRP that remains in the concentrating tube receptacle is aspirated through the second, PRP port of the concentrating tube. The “pure” PRP that is retrieved in this manner will typically exhibit a trace red blood cell concentration of less than one percent, which is far less than is achieved using conventional PRP production techniques.
In a preferred embodiment, the anticoagulant may include sodium citrate, which is typically mixed with a patient's blood in a ratio of 1:5. Preferably, the whole blood sample and the anticoagulant are mixed in a 60 ml syringe and the anticoagulated mixture is loaded into the preparation tube for the initial centrifuging step. The anticoagulated whole blood may be centrifuged for about 1.5 minutes at a speed of approximately 3800 RPM.
The common port of the preparation tube and the plasma and PRP ports of the concentrating tube may include releasable closures or caps, which are attached to the ports during the centrifuging steps and which are removed for loading or aspiration of the fluids into and out of the tubes.
After the initial centrifuge step, the cap attached to the closed port of the preparation tube receptacle is removed and the upper fluid layer containing the plasma platelet suspension is aspirated into a 60 ml plasma syringe. When a 60 ml anticoagulated whole blood sample is involved, the aspirated suspension typically has a volume of approximately 35 ml. The platelet plasma suspension is transferred to the concentrating tube receptacle through the open plasma port of the concentrating tube. Typically, both the plasma and PRP ports of the concentrating tube are formed through the upper end of the concentrating tube receptacle. After the platelet plasma suspension (which includes some remaining red blood cells) is loaded into the chamber of the concentrating tube receptacle, both the plasma and PRP ports are capped. The concentrating tube may then be centrifuged at 3800 RMPs for a duration of 5 minutes. Typically during each centrifuge step the tube that is being centrifuged is counterbalanced.
After the second centrifuge step is completed, the plasma port of the concentrating tube is opened and the top, platelet poor plasma layer is aspirated from the chamber of the centrifuge tube receptacle through the aspiration pipe and plasma port. Approximately, 7 ml of platelet concentrated buffy coat PRP remain in the bottom fluid layer of the concentrating tube, along with trace levels of red blood cells. At this point, a 12 ml syringe may be attached to the PRP port and the concentrating tube is gently swirled to resuspend the concentrated platelets in the remaining plasma. Finally, the concentrating tube is inverted and the highly concentrated PRP remaining in the tube is aspirated through the PRP port. The 12 ml syringe is then removed and capped. The concentrated or purified PRP is then ready for use in a variety of medical applications.
An alternative concentrating tube in accordance with this invention may include a single, common inlet and aspiration port formed through an upper end portion of the concentrating tube receptacle. An aspiration pipe may be communicably connected to the port and extend downwardly through a chamber of the concentrating tube receptacle. A lower end of the aspiration pipe may carry a distal nozzle. After the platelet plasma suspension is aspirated from the preparation tube, it is introduced into the chamber of the concentrating tube through the common port. The lower end of the aspiration pipe and distal nozzle are positioned within the chamber such that after the concentrating tube is centrifuged, the nozzle is proximate the bottom of the platelet poor plasma layer. Following centrifugation of the concentrating tube, the platelet plasma suspension is separated into an upper platelet poor plasma layer and a lower platelet rich plasma layer as in the previous version. The platelet poor plasma is aspirated through the nozzle, aspiration tube and single port. The remaining platelet rich plasma is swirled or otherwise agitated and additional plasma is added if desired. The concentrating tube is then angularly tilted to immerse the nozzle in the platelet rich plasma and the remaining platelet rich plasma is aspirated through the nozzle. Preferably, the aspiration pipe is flexible and the nozzle is angled toward the side wall of the receptacle so that aspiration of the remaining PRP is facilitated.
Other objects, features and advantages will occur from the following description of a preferred embodiment and the accompanying drawings, in which:
There is shown in
Tubes 12 and 14 comprise centrifuge tubes. As used herein, “centrifuge tube” or “tube” should be understood to comprise various shapes and sizes of vessels, receptacles and containers having an interior chamber for holding a fluid biological product, such as blood, and capable of being centrifuged to separate the product into constituent components. When whole blood is involved, the constituent components are usually red blood cells, plasma and platelets, which are typically mixed with white blood cells in the form of a whitish “buffy” coat. The centrifuge tubes are not limited to just tubular and elongate configurations, although such configurations will typically be used in preferred embodiments of this invention.
As depicted in
Tubular receptacle 13, as well as permanently capped upper end 15 and base 16 are typically composed of a durable plastic material such as polypropylene or other material suitable for medical or veterinary applications. Each of the tubes disclosed herein may comprise similar materials. The tube should likewise be constructed to withstand the force exerted by centrifuging. In certain applications, shatter resistant glass may be employed. Although the tube is preferably formed with a permanently capped upper end, in alternative embodiments, a removable (e.g. threadabe) cap may be utilized. Various alternative and/or analogous forms of construction are disclosed in US Patent No. '353.
Tubular receptacle 13 includes an interior chamber 18 that extends from upper end 15 to base 16. Chamber 18 accommodates blood (or, in other applications, chemicals, stem cells, bone marrow aspirant and other biological fluids/products) to be centrifuged and aspirated using tube 12.
In the version disclosed herein, receptacle 13 does not include graduated markings along the exterior side wall of the receptacle. In alternative embodiments, various types of graduated markings representing fluid volume may be formed along this side wall.
A common inlet/outlet port 32 is formed unitarily in upper end 14 of tubular receptacle 13. Port 32 includes a central opening that extends through upper end 14. An upper end of port 32 or stem 34 is disposed exteriorly of the tubular receptacle, and a lower end 36 of the port is disclosed interiorly of chamber 18. Lower end 36 may comprise a fitting or receptacle for operatively receiving a syringe that is used to introduce a whole blood product into chamber 18 of tube 12. Preferably, common inlet/outlet port 32 is composed of material similar to that forming the tube itself. The common port may be molded together with the tube in a single manufacturing process. Various alternative types of inlet/outlet ports may be employed including Leur™-type ports as are described in referenced Patent Nos. '353 and '796. A removable closure 38 is secured to the outer stem 34 of port 32 by a connecting strap 40. During the centrifuging operation, as well as at other times when fluid is not being introduced into or removed from tube 12, closure 38 is engaged with the upper stem 34 of port 32 to maintain the port in a closed condition. This is represented by the engaged closure 38a in
A vent 42 is formed through upper end 15 adjacent common port 32. The vent maintains a stable neutral pressure within tubular receptacle 13 during the aspiration process. Vent 42, which is shown in
An elongate, flexible pipe 50 is communicably engaged with the interior fitting 36 of port 32. The pipe is composed of a flexible, yet strong plastic material. Silicone or other flexible plastic material is especially suited for the pipe. Prior to the use of tube 12, pipe 50 features the elongate and relatively straight condition illustrated in
In other versions, the preparation tube may eliminate an aspiration pipe altogether. See Ser. No. 14/741,920. In such cases a vent is typically formed in a bottom portion of the tube for neutralizing pressure within the tube. The precise positioning of the common inlet and outlet port and the vent may be varied within the scope of this invention. It is critical that the common inlet and outlet port and the vent communicate with different regions of the chamber separated by the diaphragm.
As shown in
A first plasma aspiration port 132 and a second PRP aspiration port 134 are formed through upper end 115. The ports may comprise Leur™ type ports that are formed unitarily through upper end 115 in the manner shown in
A vent cap 142 is removably received in a 1-2 mm vent hole formed through upper end 115. This vent hole is selectively opened to maintain a stable neutral pressure within receptacle 112 during the aspiration process described below. The vent may be formed at various locations in the upper end of the tube.
Aspiration ports 132 and 134 communicate with interior chamber 118. The interior end of plasma port 132 includes a fitting 161 that is communicatively engaged with an elongate aspiration pipe 136. The lower end of pipe 136 carries and is communicatively connected to a distal nozzle 138. Various types of nozzles suitable for connecting, either unitarily or separately, to the lower end of the aspiration pipe of the concentrating tube will be known to persons skilled in the art and may be employed within the scope of this invention. Although in the embodiments depicted herein the nozzle fits into the lower end of the aspiration pipe (See
Preparation tube 12 and concentrating tube 112 are utilized to manufacture a highly concentrated or “pure” PRP product for medical applications in accordance with the method M set forth in
The system and method of this invention may be used to process various volumes of whole blood to produce a highly concentrated volume of PRP. Due to the size parameters and specifications of the centrifuge tubes, available syringes and standard centrifuge machines, a 50 ml whole blood sample is a convenient and practical volume to process in accordance with this invention. Referring to the diagram of
First, as shown in
The capped tube 12 is loaded in a known manner into a standard centrifuge machine, which is suitable for centrifuging and separating blood products and similar applications. An Executive Series Centrifuge II™ machine or similar apparatus may be used for this purpose. The preparation tube is counterbalanced by placing a comparable volume of liquid in a second tube and installing that tube directly opposite tube 12 in the rotor of the centrifuge machine. The centrifuge lid is closed and the machine is set to a preferred speed of 3800 RPM and for an operating time of 1.5 minutes. These specifications may be varied within the scope of this invention as described below. The centrifuge machine is operated, step 206 in
As shown in
Syringe 302 is next operatively attached to plasma port 132 of concentrating tube 14. See
Concentrating tube 14, which contains the platelet plasma suspension (PPS) is next fully capped by reattaching cap 135 to port 132, as indicated by engaged cap 135a (
After the concentrating tube 14 has undergone the second centrifuging stage, it is removed from the centrifuge machine. Most, if not all of the PPP layer is located above the distal nozzle 138 of aspiration pipe 136. By the same token, most if not all of the PRP layer is located below nozzle 138, step 214 (
The PRP remaining in the bottom of tube 14 is in the form of a white, highly platelet concentrated plasma in the form of a whitish buffy coat containing trace amounts of red blood cells. Plasma may be added to PRP level via plasma port 132 to dilute the PRP and attain more volume if necessary. After the addition of additional plasma, port 132 is re-capped and the platelet buffy coat is re-suspended into the added plasma by gently swirling or agitating the device, step 220. As shown in
Syringe 310 contains the highly platelet concentrated PRP which will contain only a very small, trace concentration of red blood cells (i.e. 1% or less). This is a significant reduction of red blood cells from the amount typically present in PRP manufactured in accordance with conventional, prior art principals. In such cases, red blood cell concentrations of 15% or more are commonplace. The significant reduction in red blood cell concentration and the proportionately increased concentration of medically effective platelets provides for a significantly improved and more medically effective PRP product. The highly concentrated and effectively “pure” PRP produced by the method of this invention is achieved only by using the novel two stage centrifuging process and system set forth by this invention. It is particularly important that the centrifuging parameters of speed and time by followed so that separation of the constituent blood components occurs in a sequence that effectively separates a greater percentage of red blood cells from the PRP while retaining a greater proportion of platelets than has heretofore been accomplished. As a result, a high quality and therapeutically superior product is obtained which can be used in a wide variety of surgical, wound care, dental, bone regeneration and other medical applications. The manufacturing process is also commercially efficient and allows high quality and highly concentrated PRP to be produced using commercially available equipment and without the need for technically complicated and/or unavailable equipment and procedures.
In alternative embodiments, the various centrifuge tubes disclosed in Patent No. '353 may be used to separate the platelet plasma suspension into PPP and PRP layers. Those layers can then be sequentially aspirated without inverting the tube, either through respective aspiration pipes or using a single sliding pipe as disclosed by that reference. Typically, in these versions the concentrating tube is centrifuged twice as disclosed in Patent No. '353. By the same token, the Progenikine™ tube disclosed in Ser. No. 14/741,920 may be employed as the preparation tube and utilized as disclosed in that reference to prepare the platelet plasma suspension that is introduced into the concentration tube. The process of the invention nonetheless achieves particularly preferred results (i.e. improved platelet concentrations and reduced red blood cell concentrations) by employing the centrifuge operating parameters (speed and duration) and the concentrating tube specifications described herein by operating the centrifuge for only 1% minutes of approximately 3800 rpm during centrifugation of the preparation tube. Two discrete fluid layers (platelet plasma suspension (PPS) and red blood cells (RBC)) are produced rather than the three discrete layers created by centrifuging blood product for 10 minutes, as has been performed previously. The PPS is capable of being further separated and concentrated within the concentrating tube, as described herein, so that increased platelet and greatly reduced red blood cell concentrations are achieved.
As shown in
An alternative concentrating tube 14a is depicted in
In this version, concentrating tube 14a includes a single, common inlet and aspiration or outlet port 132a, which again comprises a self-sealing valve port, which is standard in the centrifuge industry. Port 132a and a pressure neutralizing vent 142a are formed through the upper end 115a of receptacle 112a in communication with interior chamber 118a. More particularly, a flexible aspiration pipe 136a is communicably connected to the inner end of port 132a and extends downwardly through chamber 118a such that a nozzle 138a carried at the lower end of pipe 136a is positioned within the platelet poor plasma layer of the aspirated platelet plasma suspension following centrifugation of the concentrating tube. More particularly, nozzle 138 is angled such that it generally points toward and is proximate the sidewall of receptacle 112a. This positioning of the nozzle is particularly effective for performing the process of this invention as described more fully below.
The process of this invention may be performed using any of the preparation tubes described herein in combination with the concentrating tube shown in
As shown in
Next, an empty 12 ml syringe 309a is attached to the port 132a as shown in
After the platelets have been re-suspended within the plasma, the concentrating tube 114a is tilted as shown in
The use of the anticoagulant sodium citrate in PRP production also constitutes a novel and significantly improved feature of this invention. To date, the anticoagulant
ACDA has been universally used in the production of PRP in order to prevent blood clots, which can interfere with effective separation of the blood constituent components during the production process. ACDA is fairly acidic and features a pH of approximately 6.8-7.2. This causes PRP that has been treated with ACDA to have very painful side effects for the patient. Nonetheless, ACDA is virtually always used as an anticoagulant because it includes dextrose, a food source which allows the blood product to be stored for up to 30 days. I have determined that such storage is unnecessary in perfusion and PRP applications inasmuch as the produced PRP is almost always used at the point of patient care. It is usually unnecessary to store the PRP product for any length of time at all. Accordingly, the dextrose contained in ACDA is not needed in such applications. Sodium citrate, on the other hand, lacks dextrose and features a normal blood pH of 7.35-7.45. As a result, it does not exhibit the painful patient side effects when used as an anticoagulant for PRP. Sodium citrate is therefore less painful and a much more effective anticoagulant to use when performing medical procedures involving PRP therapy.
From the foregoing it may be seen that this invention provides for a method and system for more effectively concentrating blood platelets for use in medical applications. While this detailed description has set forth particularly preferred embodiments of the apparatus of this invention, numerous modifications and variations of the structure of this invention, all within the scope of the invention, will readily occur to those skilled in the art. Accordingly, it is understood that this description is illustrative only of the principles of the invention and is not limitative thereof.
Although specific features of the invention are shown in some of the drawings and not others, this is for convenience only, as each feature may be combined with any and all of the other features in accordance with this invention.
Number | Date | Country | |
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62013870 | Jun 2014 | US |