Shedding light in the controversial terminology for platelet-rich products: Platelet-rich plasma (PRP), platelet-rich fibrin (PRF), platelet-leukocyte gel (PLG), preparation rich in growth factors (PRGF), classification and commercialism

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Published: Wednesday, 22 July 2015 10:49 Written by 

A recent series of letters were published in JBMR-A1,2 about platelet concentrates for surgical use, where both terminology and content of these materials were hotly debated. The definition and classification of the platelet concentrate products are indeed very important issues, as many misunderstandings are widely spread in the large literature on this topic.3 These techniques were initially gathered under the name ‘‘platelet-rich plasma (PRP),’’4 in reference to the
generic term used in transfusion hematology, but this nameis too general for the qualification of the many products developed now. In the first letter, Everts et al.1 insisted on the presence of leukocytes in most platelet preparations for surgical use. These authors explained a very important truth that many PRPs were in fact leukocyte- and platelet-rich plasmas (LPRPs), and that the presence of leukocytes in these surgical adjuvants may be highly beneficial. They thus, introduced the term of ‘‘platelet-leukocyte–rich plasma (P-LRP).’’ Moreover, they pointed out that the two activation forms of the product (liquid platelet suspension or gelified fibrin-platelet clot) have different characteristics, and that the concentrates activated with a fibrinogen-cleaving agent (thrombin, batroxobin) should be named in fact as ‘‘platelet-leukocyte gels (PLG).’’ In this letter, these authors resumed the clarification process of the platelet concentrate definitions started in 2006.5 However, their proposals for terminology were not complete and have been improved and systematized in the recent publication of a wide classification system for these products.3 The first concern is that all PRPs do not contain leukocytes. Many PRPs obtained from cell separator units or from the Anitua’s preparation rich in growth factors (PRGF) subfamilies do not contain leukocytes and were classified as pure PRP (P-PRP).3 On the contrary, PRPs containing leukocytes were classified as L-PRP: this acronym seems obviously more logical and reader-friendly than P-LRP, but we agree that a consensus should be found to solve this issue once for good

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