[Question #10142] Hepatitis from Centrifuge Contamination

25 months ago

I recently had oral surgery with a procedure called platelet rich fibrin (“PRF”), where they draw a few tubes of your own blood, spin them in a centrifuge, then extract the white blood cells to create membranes placed on the wound.

While the blood inside of the vacutainers is sterile and the metal plates//bowls they pour everything onto to create the PRF are also sterile, my concern is that the centrifuge is not regularly cleaned out. In the process of drawing multiple patients’ blood, the outside of the tubes could become contaminated from the inside of the centrifuge if any blood leaked onto tubes during previous blood draws. The dentist has to touch the tubes while he’s creating the PRF and then proceeds to continue to conduct surgery with the same gloves. (The PRF step is done in the middle of surgery.)

If there were dried blood in the centrifuge, would it “stick” to the vacutainer tubes or would it not "fly off" if dried during the spinning process? My concern is hepatitis or another infectious disease via the dentist touching the tubes then touching an open extraction wound.

H. Hunter Handsfield, MD

25 months ago

Welcome and thanks for your confidence in our services, but your question is a bit off topic for this forum. The three main hepatitis viruses (A, B,C) are often considered STDs, but in fact are very rarely sexually transmitted, and we are not necessarily experts on nonsexual transmission or in prevention of blood borne infection in medical settings. That said, I believe I can accurately address your concerns.

In the US and probably all industrialized countries, standard procedures for handling and processing blood and blood-based clinical products -- which in most setting are required by law -- are highly effective. Aside from non-medical procedures like injection drug use, currently there are virtually no cases of these viruses acquired through blood. Almost certainly it is fair to assume the office, clinic (or blood bank) that manages your blood and others uses these procedures routinely, including testing of all blood samples coming in contact with the commonly used equipment, assuring patients and donors are immunized against HBV, and routine disinfection procedures. Not being an expert in this area, I don't know any more details and cannot comment specifically on protection against centrifuge contamination or your dentist's gloving procedures, but I really can't imagine you are at risk. If you remain in doubt or otherwise concerned, I would encourage you to discuss this with the office or clinic where your oral surgery was done.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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25 months ago

Thanks so much for your response, Dr. Handsfield. Just to clarify, the blood that was used for my procedure was my own. Nothing is tested for these procedures because it's the person's own blood going back into their body. I suppose my question was more of a worst-case scenario question about whether non-visible dried blood getting onto one of my tubes when it was placed in the centrifuge and then touched by my dentist, was something to be concerned about. But I certainly understand that my question is a bit out of the topic of STDs. If you have anything to add based on my clarification above, I would appreciate it. If not, you may close this thread. Thanks so much!

H. Hunter Handsfield, MD

25 months ago

I understood it was your own blood, but any potential contamination would have to be someone else's. I have explained that I think that's extremely unlikely, and the reasons. I really can't say more than I have. The absence of any known/reported cases of blood borne infections from exposures, treatment or diagnostic procedures in doctors' offices or in any medical establishment for at least the past 2-3 decades should be reassuring.---
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