What effect do anticoagulants have?
Growth Factor Release
Inflammatory and Healing Response
Common PRP Systems: Anticoagulant Use and Clinical Implications
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PRP system
Anticoagulant
Juventix
ACD-A
Arthrex Angel
ACD-A
Emcyte
Sodium Citrate
Regen
Sodium Citrate
Cellenis
MNC7
Harvest
ACD-A
Dr. PRP
ACD-A
Integrity
ACD-A
Progen
ACD-A
Apex Xcell
ACD-A
CARE stream
ACD-A
Selphyl
Sodium Citrate
EZ Gel
none
Summary
The type and amount of anticoagulant in a PRP system directly affect platelet yield, growth factor release, and clinical outcomes. Juventix and most leading competitors use ACD-A for optimal efficacy and safety, while systems using ACD may require additional steps to achieve similar results. Avoid EDTA and heparin for regenerative purposes.
Based on the most recent and relevant sources, there is a list of vendors below that offer PRP tubes or systems with EDTA and/or heparin as anticoagulants. It is important to note that while these anticoagulants are available, their use in clinical PRP therapy is generally discouraged due to negative effects on platelet function and regenerative efficacy. Most clinical PRP systems use sodium citrate, ACD-A, or ACD instead. Vendors below may serve research, laboratory, or veterinary markets, and not all are intended for human regenerative medicine.
Vendors—including ZenBio, HBH Medical, Siny Medical, YBO Medical, PRPmed.de, and IPPOCARE—offer PRP tubes with EDTA and/or heparin. DO NOT USE THESE
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- Acid Citrate Dextrose (ACD-A): While ACD-A may yield fewer platelets than EDTA, its ability to maintain platelet functionality and growth factor potency makes it the gold standard for clinical PRP therapy. Buffering post-preparation is essential to neutralize acidity and maximize therapeutic benefits 1,5.
- EDTA: Strong chelator, yields high platelet counts but can alter platelet shape and reduce biological efficacy.
- Heparin: Can cause platelet aggregation and inaccurate counts; should not be used in modern PRP systems.
- Composition: Sodium citrate is a single compound (trisodium citrate), while ACD-A is a solution containing sodium citrate, citric acid, and dextrose in specific proportions 3,6.
- Anticoagulant Action: Both prevent clotting by chelating calcium in the blood, but ACD-A's additional components (citric acid and dextrose) help preserve platelet function and viability more effectively during PRP preparation 3,4.
- Clinical Preference: ACD-A is considered the gold standard and is FDA-approved for PRP because it better maintains platelet integrity and growth factor release compared to sodium citrate alone 1,3,4.
- Patient Experience: Some studies note that PRP prepared with sodium citrate may cause less discomfort during injection compared to ACD-A, but ACD-A remains preferred for optimal platelet preservation and clinical outcomes 2,3.
- SC: Maximizes growth factor and cytokine release from activated platelets.
- ACD: Acceptable if calcium is replaced before use; otherwise, growth factor release may be suboptimal.
- EDTA/Heparin: Impairs growth factor release and may alter cytokine profiles.
- SC: Low inflammatory risk, supports MSC proliferation and tissue healing.
- ACD: May delay healing or cause minor inflammatory papules in some patients.
- EDTA/Heparin: Not recommended for regenerative medicine due to negative effects on platelet function and higher contamination risk.
- ACD-A: May induce inflammatory response.
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