Anticoagulant Citrate Dextrose Solution, commonly known as ACD-A or Solution A is a non-pyrogenic, sterile solution. This element is utilized as an anticoagulant in the production of platelet-rich plasma (PRP) with PRP Systems for extracorporeal blood processing. Anticoagulants that are citrate-based use the ability of citrate ion to chelate ionized calcium that is present in the blood to prevent the coagulation of blood and form a non-ionized calcium-citrate complex.
The only anticoagulant product that the United States Food & Drug Administration have approved to be used for the preparation of PRP in various PRP Systems is the ACD-A. According to a research carried out in 2016 on PRP obtained with various anticoagulants and their effects on the behavior of mesenchymal stromal cells in vitro and platelet numbers, there are favorable results in the usage of PRP for musculoskeletal tissue repair.
For isolating platelets it is advised to replace the standard sodium citrate for Acid Citrate Dextrose (ACD-A) as the isolation procedure requires multiple washing steps. Platelets are more stable at 37C during spinning, but spinning them at room temperature (25 C) also works fine. Reducing the pH through ACD-A (it gets near 6.5) helps to impair activation of residual thrombin traces in the platelet tubes, and contributes to the overall maintenance of platelet morphology while shifting function to a minima. Normally you need to resuspend platelets to a proper Tyrode Buffer (pH 7.4) in order to recover their functionality. ACD has many advantages when it comes to preserve platelets
When ACD was used, the results showed higher platelet yield in overall blood. However, the usage of EDTA also encouraged growth in the mean platelet volume after the blood centrifugation steps were executed to obtain PRP. Next, the use of ACD resulted in increased proliferation of mesenchymal stromal cells. Therefore, it was concluded that anticoagulants including ACD-A play a major role in PRP preparation and help optimize the process to a great extent.