This study was supported by the AETS, Instituto Carlos III, Spain (Grant PI05/90173).
Efficacy and safety of the use of autologous plasma rich in platelets for tissue regeneration: a systematic review
Article first published online: 14 OCT 2008
© 2008 American Association of Blood Banks
Volume 49, Issue 1, pages 44–56, January 2009
How to Cite
Martínez-Zapata, M. J., Martí-Carvajal, A., Solà, I., Bolibar, I., Ángel Expósito, J., Rodriguez, L. and García, J. (2009), Efficacy and safety of the use of autologous plasma rich in platelets for tissue regeneration: a systematic review. Transfusion, 49: 44–56. doi: 10.1111/j.1537-2995.2008.01945.x
This study was presented in part at the 10th LatinCLEN Congress, Barcelona, Spain, June 13-16, 2007.
- Issue published online: 23 DEC 2008
- Article first published online: 14 OCT 2008
- Received for publication June 19, 2008; revision received August 11, 2008; and accepted August 12, 2008.
BACKGROUND: Autologous plasma rich in platelets (PRP) is a derived blood product whose application in clinical practice is growing. A systematic review was conducted to evaluate its efficacy and safety.
STUDY DESIGN AND METHODS: A search was performed in electronic databases. Randomized controlled clinical trials (RCTs) in adult patients were included and assessed for methodologic quality. The main outcomes were “tissue regeneration” and “safety.” Relative risks (RRs) and standardized mean differences (SMDs) were calculated to show pooled estimates for these outcomes. When the results heterogeneity was more than 50 percent, a sensitivity analysis was performed.
RESULTS: Twenty RCTs were included (11 of oral and maxillofacial surgery, 7 of chronic skin ulcers, and 2 of surgery wounds). Four RCTs evaluated the depth reduction in gingival recession in chronic periodontitis; the SMD was 0.54 (95% confidence interval [CI], 0.16 to 0.92) mm, favorable to PRP. Three RCTs evaluated the clinical attachment level in chronic periodontitis; the SMD was 0.33 (95% CI, −0.71 to 1.37) mm. Six RCTs assessed the complete skin epithelialization in wound ulcers; the RR was 1.40 (95% CI, 0.85 to 2.31). Only 6 RCTs reported adverse effects without differences between groups.
CONCLUSIONS: PRP improves the gingival recession but not the clinical attachment level in chronic periodontitis. In the complete healing process of chronic skin ulcers, the results are inconclusive. There are little data about PRP safety. There are several methodologic limitations and, consequently, future research should focus on strong and well-designed RCTs that assess the efficacy and safety of PRP.