Efficacy of platelet-rich plasma as a shielding technique after endoscopic mucosal resection in rat and porcine models

Abstract

BACKGROUND AND STUDY AIMS: The aims were to assess the efficacy of endoscopic application of Platelet-rich plasma (PRP) to prevent delayed perforation and to induce mucosal healing after endoscopic resections. PATIENTS AND METHODS: Colonic induced lesions were performed in rats (n = 16) and pigs (n = 4). Animals were randomized to receive onto the lesions saline (control) or PRP. Animals underwent endoscopic follow-up. Thermal injury was assessed with a 1 - 4 scale: (1) mucosal necrosis; (2) submucosal necrosis; (3) muscularis propria necrosis; and (4) serosal necrosis RESULTS: Saline treatment showed 50 % of mortality in rats (P = 0.02). Mean ulcerated area after 48 hours and 7 days was significantly smaller with PRP than with saline (0.27 +/- 0.02 cm(2) and 0.08 +/- 0.01 cm(2) vs. 0.56 +/- 0.1 cm(2) and 0.40 +/- 0.06 cm(2); P < 0.001). The incidence of thermal injury was significantly lower with PRP (1.25 +/- 0.46) than in controls (2.25 +/- 0.50); P = 0.006. The porcine model showed a trend toward higher mucosal restoration in animals treated with PRP than with saline at weeks 1 and 2 (Median area in cm(2): 0.55 and 0.40 vs. 1.32 and 0.79) CONCLUSIONS: Application of PRP to colonic mucosal lesions showed strong healing properties in rat and porcine models.