Platelet-rich plasma: how safe is it, and can it cause irreversible blindness?
Platelet-rich plasma (PRP) is not a new treatment. It has been around for a long time, but it is still very much misunderstood and there are many unanswered questions about it. It is known that it is autologous, meaning that it comes from the patient's own body, and, therefore, allergic reactions cannot occur to one's own blood and the body will not reject it. Despite this, questions still remain around whether it is completely safe. There are several articles that briefly touch on the safety of PRP, but they do not delve into the topic deep enough. As clinicians already know from other medical aesthetic procedures, none are 100% safe and they all come with potential risks and complications. Therefore, it is worth asking whether PRP is any different.
In this article, the author discusses PRP from a safety perspective and dissects three clinical papers that highlight that there have been six reported cases of blindness from this treatment.
In 1952, Stanley Cohen and Rita Levi-Montalcini discovered growth factors, and this research opened the door for platelet-rich plasma (PRP). They were awarded a Nobel Prize for their work in 1986 (Santos et al, 2010). Furthermore, Cohen went on to discover epidermal growth factor (EGF) in 1962, platelet-derived growth factor (PDGF) in 1974 and vascular endothelial growth factor (VEGF) in 1989.
According to Hurjui et al (2020), the term ‘PRP’ was first used by Kingsley et al (1954) to refer to the standard platelet concentrate for transfusion (Mościcka and Przylipiak, 2021). Matras (1972) used platelets for the first time as a sealant to establish blood homeostasis during surgical procedures and Oon and Hobbs (1975) were the first scientists to use PRP in reconstructive treatments (Mościcka and Przylipiak, 2021). Furthermore, Knighton et al (1986) were the first to describe platelet concentrate protocols and referred to them as autologous platelet-derived wound healing factors (PDWHF) (Mościcka and Przylipiak, 2021). Later, Ferrari et al (1987) used PRP in heart surgery as an autologous source of transfusion, thus reducing intraoperative blood loss. Since the 1980s, PRP has been widely used in regenerative medicine. Further development in the application of PRP in dentistry occurred after Choukroun et al (2006) discovered platelet-rich fibrin (PRF), which is a type of platelet concentrate that does not use the addition of anticoagulants.
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