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Everything You Need to Know About ACD-A

Published: 03/27/2023

If you’ve been researching PRP, you’ve probably come across the various types of anticoagulants used. They all have strengths and weaknesses, so which one is best? EDTA? Heparin?

From our years of experience, ACD-A is the gold standard when it comes to anticoagulants for PRP preparation.

Here are some of the most frequently asked questions we receive about ACD-A.

What is Anticoagulant Citrate Dextrose Solution / ACD used for?

Anticoagulant citrate dextrose solution formula A, also known as ACD-A, is a sterile solution approved by the U.S. Food and Drug Administration (FDA) for use in platelet-rich plasma (PRP) preparation. Ingredients of the solution include:

  • Trisodium citrate
  • Citric acid
  • Dextrose

Anticoagulants are necessary to maintain the fluidity of blood once it has been drawn from your body. That’s because the foreign surface of a tube such as the Dr. PRP Kit can activate platelets and lead to clotting. ACD also makes the blood more acidic than normal.

What is the Difference Between ACD-A and ACD-B?

Both ACD-A and ACD-B contain sodium citrate, citric acid, and dextrose, but they vary in their composition:

ACD-A consists of the following:1

  • Trisodium citrate, 22.0 g/L
  • Citric acid, 8.0 g/L
  • Dextrose, 24.5 g/L

ACD-B is composed of:2

  • Trisodium citrate, 13.2 g/L
  • Citric acid, 4.8 g/L
  • Dextrose, 14.7 g/L

How Does ACD-A Prevent Clotting?

Citrate-based anticoagulants like ACD-A prevent coagulation by chelating ionized calcium present in the blood to form a non-ionized calcium-citrate complex.

As mentioned previously, ACD-A also has an acidifying effect. When ACD-A is added, the pH of blood drops to about 6.5, which can help maximize platelet recovery and impair activation of residual thrombin.3 This can have a negative effect on the half-life of growth factors, so we recommend using a buffer to bring the PRP pH back to a physiologic range prior to injection.

Why is ACD-A Used for PRP Preparation?

PRP preparation can be quite extensive, and careful attention and handling is needed to ensure that the blood sample remains stable and usable.

This is where anticoagulants come in. If the patient’s PRP can’t be processed immediately for whatever reason, anticoagulants will prevent clotting in the PRP tube. And because anticoagulants chelate ionized calcium in blood, they also help preserve the hemostatic functionality of platelets for up to 7 days.4

The choice of anticoagulant has a strong impact on PRP quality. In one study, researchers compared the microstructure changes of platelets after the addition of various anticoagulants, including ACD-A. They concluded that ACD is an optimal anticoagulant for PRP production because of its ability to maintain platelet structural integrity. They also found that PRP prepared using ACD-A released significantly more transforming growth factor beta-1 (TGF-ꞵ1) than two other types of anticoagulants, heparin and citrate.5

Can ACD Solution B be used for PRP?

ACD-A is the only solution approved by the FDA for PRP.

Which Anticoagulant is Best for PRP?

Each anticoagulant used for PRP has its pros and cons. Generally, clinicians prefer not to use EDTA due to concerns about its ability to damage platelets. Loss of platelet function may lead to loss or reduction of growth factors, which defeats the purpose of PRP therapy. However, EDTA is highly efficient at inhibiting platelet aggregation and can therefore have a positive influence on platelet collection for PRP.6

To our knowledge, ACD-A preserves platelets and their function better than other anticoagulants used for PRP. It also has no adverse effects on leukocytes and other cells involved in tissue regeneration.7 Therefore, ACD-A is the best anticoagulant in PRP preparation.

Help Your Patients Heal With Only the Best – ACD-A

PRP delivers a whole new meaning to the word “healing.” Whether a patient is suffering from chronic pain or hair loss, PRP presents a non-invasive, safe, and effective treatment option.

But the quality of your PRP matters. Unfortunately, the world of PRP can quickly become confusing, if not overwhelming.

We’re here to help. If you’d like to learn more about ACD-A and why Dr. PRP uses it over other anticoagulants, we’d love to hear from you. Contact us today at (844) 377-7787 (DR-PRP-US). You can also view and order Dr. PRP kits and centrifuges directly through our online store.

References:

  1. https://www.fda.gov/media/155643/download
  2. https://www.fda.gov/media/155643/download
  3. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1537-2995.1969.tb05536.x
  4. https://www.frontiersin.org/articles/10.3389/fbioe.2020.00223/full
  5. https://pubmed.ncbi.nlm.nih.gov/26665933/
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7148468/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7148468/