The Publications Book
The Heidari Publications
94 publications · 23 years of research · click or drag a page corner to turn
Royal College
British Orthopaedic
AO Trauma
Churchill
Limb Recon
Specialist Reg.
Rahman E, Rao P, Abu-Farsakh HN, et al.; Heidari N (collaborator).
Background: Platelet-rich plasma (PRP) is widely used in various medical and surgical specialties for its regenerative properties, including aesthetics (facial rejuvenation, hair restoration, and skin tightening) and orthopedics (treatment of tendinitis and osteoarthritis). However, the inconsistent literature on PRP's efficacy and safety leads to critical knowledge gaps. This systematic review evaluates quality control measures in PRP preparation and application and explores the regulatory environment governing its clinical use. Methods: Following PRISMA guidelines, a comprehensive search was conducted across multiple databases, including PubMed, EMBASE, and Web of Science, for studies published from January 2020 to April 2024. The review included randomized controlled trials (RCTs) involving human participants undergoing PRP treatment for aesthetic or regenerative purposes. Key parameters such as the PRP preparation methods, platelet concentration, and quality control measures were analyzed. The study protocol was registered with PROSPERO (ID: CRD42024557669). Results: Out of 75 RCTs involving 5726 patients, the review identified significant variability in PRP preparation methods and application techniques, including differences in centrifugation protocols and platelet concentration levels. A new evidence-based scoring system, the William-Eqram Scoring System for PRP Quality Reporting (WESS-PQR), was proposed to address these inconsistencies. Correlation analysis revealed a strong positive correlation (r = 0.79) between proper temperature control during preparation and PRP efficacy. Initial platelet count assessment showed a moderate positive correlation (r = 0.57) with efficacy. Conclusions: Standardized PRP preparation protocols and robust regulatory frameworks are urgently needed to ensure the safety and efficacy of PRP treatments. The proposed WESS-PQR scoring system can serve as a valuable tool for clinicians and researchers, promoting consistency and reliability in PRP applications.
What did we look at?
Every published high-quality trial of platelet-rich plasma (PRP) across medicine and surgery — 75 randomised controlled trials covering nearly 6,000 patients — to identify what makes some PRP treatments work and others fail.
Why did we look at it?
PRP — concentrated platelets prepared from a patient’s own blood — is now used in dozens of conditions, from joint pain to hair loss. The clinical results vary enormously. We wanted to find out whether the variation is in the underlying biology, or in how the PRP is prepared and delivered.
What did we find?
The variation is in the preparation. Specifically, temperature control during preparation correlated strongly (r = 0.79) with efficacy. Other key variables: centrifuge speed, anticoagulant choice, and platelet concentration in the final product. We proposed a scoring system (WESS-PQR) for reporting PRP quality so that future trials can be properly compared.
What does this mean for patients?
If you’re considering PRP for any condition, the question to ask is not just “does PRP work for X?” but “how is the PRP prepared in this clinic?”. Preparation is a major determinant of whether the treatment will help.
Journal of Clinical Medicine 2024. PMID: 39124838.