Efficiency and safety of autologous platelet-rich plasma

The purpose of this literature review is to provide relevant research results on the efficiency and validity of the platelet-rich plasma in various fields of medicine as well as to cover some unresolved issues and problems in this area. If one searches the keywords such as «platelet-rich plasma», «safety», «effects» in the Scopus and PubMed databases, 590 publications will be found over the past 5 years, most of which are in the field of orthopedics, gynecology and dermatology. Autologous plasma enriched with platelets is widely used today in various fields of medicine. The platelet-rich plasma is so widely used because it releases numerous chemokines, cytokines, and growth factors that stimulate angiogenesis, extracellular matrix remodeling, and cell differentiation and proliferation. Numerous studies have shown positive local effects of the platelet-rich plasma: earlier vascularization, epithelialization, remodeling and tissue regeneration. However, current studies on the clinical efficiency of the platelet-rich plasma are not conclusive and homogeneous. The heterogeneity of the platelet-rich plasma specimens (different preparation methods, various concentrations of platelets and growth factors, the influence of age, sex, concomitant pathology of the patient) complicates the interpretation of the existing literature and limits the ability to give definitive recommendations on the clinical efficiency of the platelet-rich plasma. Presently, there is no comprehensive standard algorithm for the platelet-rich plasma preparation as well as no definite criteria for establishing indications for this procedure. The following issues remain unresolved: finding an effective method to prepare the platelet-rich plasma, determining the optimal concentration of platelets and growth factors, having insufficient knowledge about all molecular mechanisms of the platelet-rich plasma to promote tissue regeneration and systemic reactions to the introduction of the platelet-rich plasma. Further research is required to address all the issues raised.