Impact of BMI and PRP Platelet and Red Blood Cell Content on the Coagulation Kinetics of Ortho-R/PRP Mixtures

Ortho-R (ChitogenX Inc., Kirkland, QC, Canada) is a lyophilized chitosan formulation that also contains calcium chloride and trehalose. Ortho-R was designed to be solubilized in autologous platelet-rich plasma (PRP), a blood-derived component, in order to become an injectable implant that augments the surgical repair of soft tissues. The Ortho-R/PRP formulation coagulates post-application, similarly to blood. Having the ability to predict the speed of coagulation of an Ortho-R/PRP mixture prepared with PRP isolated from a specific patient would be an advantage in the operating room. The purpose of this study was to investigate whether human donor characteristics (age, sex, body mass index, habits) and autologous PRP properties would have an impact on Ortho-R/PRP mixture coagulation. Clot maximal amplitude and shear elastic modulus were significantly positively correlated with body mass index and platelet concentration in the isolated PRPs. Clot formation time, maximal amplitude and shear elastic modulus were all negatively correlated with PRP red blood cell concentration (and associated hemoglobin and hematocrit content). Donor characteristics were not good predictors of coagulation kinetics in Ortho-R/PRP mixtures. Some of the isolated PRP properties were better predictors of Ortho-R/PRP coagulation kinetics. However, predicting how an Ortho-R/PRP mixture from a particular patient will coagulate is very difficult since all PRP isolation devices yield heterogeneous PRPs and analysis of the isolated PRPs occurs post-administration.