Molecular and Regenerative Effects of Platelet-Rich Plasma and Related Hemocomponents in Animal Models of Liver Injury-A Systematic Review.

Abstract

Platelet-rich plasma (PRP) has been increasingly explored as a biologic strategy for liver repair; however, preclinical studies have evaluated not only intact PRP but also PRP related hemocomponents with distinct biological properties, complicating interpretation and translation of the evidence. A systematic review of experimental studies was conducted to assess the effects of PRP and related hemocomponents in animal models of liver injury, focusing on molecular, metabolic, biochemical, and histological outcomes, and evaluating methodological quality and risk of bias using the Cochrane ROB 2.0 framework. Fourteen eligible studies were identified across toxic, cholestatic, parasitic, radiation-induced, and surgical models. Platelet-based interventions were generally associated with hepatoprotective, antifibrotic, antioxidant, immunomodulatory, and pro-regenerative effects; however, responses were highly context dependent and varied according to injury etiology, disease stage, administration route and timing, and the frequent use of combination therapies. Substantial heterogeneity in the platelet-based products evaluated-including platelet supernatants and lysates-and inconsistent reporting of key compositional parameters limited product classification, cross-study comparability, and mechanistic interpretation, while ROB 2.0 assessments revealed predominantly some concerns of bias. PRP and related hemocomponents show biologically relevant effects in experimental liver injury, but their translational potential is constrained by methodological heterogeneity and inadequate product characterization. Standardized reporting, controlled comparative designs, and clinically relevant models are required to clarify efficacy and support rational translation.