103
Autologous Thrombin: Continuing Studies

1524-475X

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Background: As many as 500,000 patients are exposed to bovine thrombin (BT) annually. This is increasing with the use of autologous platelet gel (PG) in surgery and in the treatment of chronic wounds (diabetic ulcers). The development of anti-phospholipid antibodies after exposure to bovine thrombin is of concern. We compared the kinetics of growth factor release by autologous thrombin (AT) to BT. Methods: Whole blood is incubated with 95% ethanol and then centrifuged in the SmartPReP™2 system (Harvest Technologies, Plymouth, MA) simultaneously with the preparation of a platelet concentrate (PC). The supernatant containing thrombin activity is collected. Clotting studies were done. The kinetics of growth factor release was determined by collecting the supernatant from the PG at 2 hours and daily thereafter for 7 days. The PC’s were prepared in two concentrations by adjusting the volumes to 10 mL and 7 mL. The activation of the PC was done at a 10:1 ratio (PC:BT) at 7 mL and 10 mL and 3:1 and 5:1 (PC:AT) at 7 mL. Results: Following a 45 minute incubation period the mean clotting time of PC by AT at a 3:1 ratio was 14.3 sec and at a 5:1 ratio was 22 sec (n = 13). Thrombin activity remained stable for 6 hours. Baseline PDGF-AB levels with AT was 50 ng/mL with a maximum of 106 ng/mL. BT using a 10 mL PC had a baseline level of 100 ng/mL with no increase over time. TGF-B1 studies demonstrated an immediate release of 98 ng/mL with a maximum level of 168 ng/mL for AT compared to BT with an initial level of 107 ng/mL and a maximum of 152 ng/ml. Conclusions: AT produces a sustained release of growth factors during a seven-day period that is similar to BT at a 10:1 ratio. AT can be prepared simultaneously with the preparation of a PC.

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