Archives of Advances in Biosciences

Vol. 16 No. 1 (2025)

Biological Mechanisms and Therapeutic Potential of PRP-Fibrin Glue in Managing Refractory Pleural Effusion: Insights from a Pilot Study

Archives of Advances in Biosciences, Vol. 16 No. 1 (2025), 2 March 2025 , Page 1-9
https://doi.org/10.22037/aab.v16i1.50478

Abstract

Introduction: Refractory pleural effusion (RPE) is a serious postoperative complication of cardiac surgery that often persists despite conventional chest tube drainage. Platelet-rich plasma fibrin glue (PRP-FG), a biologically active sealant with hemostatic and regenerative properties, has previously shown efficacy in reducing morbidity in postoperative chylothorax and pneumothorax. This clinical trial aimed to evaluate the safety and therapeutic efficacy of intrapleural PRP-FG in patients with RPE unresponsive to standard thoracostomy management.

Case Presentation: In this pilot clinical trial, 19 patients with unilateral or bilateral RPE resistant to standard therapy were treated with intrapleural PRP-FG. Treatment success was defined as pleural drainage of <50 mL/day for two consecutive days within one week post-intervention, accompanied by symptomatic improvement.

The mean age was 43.6 ± 19.6 years; 52.6% of patients had undergone coronary artery bypass grafting (CABG), and 36.8% had undergone congenital cardiac surgery. PRP-FG administration led to a significant reduction in effusion volume (624.2 ± 275.0 mL to 25.0 ± 20.1 mL; mean difference 599.2 mL, p < 0.001; Cohen’s d = 2.29). Five patients (26.3%) required a second application, and three (15.8%) required a third for complete resolution. No major adverse events or recurrence were observed during the six-month follow-up; minor, self-limited effects included pleuritic pain and transient dyspnea. One patient with uncontrolled diabetes died from a sternal wound infection unrelated to PRP-FG.

Conclusion: Intrapleural PRP-FG appears to be a safe, effective, and minimally invasive therapy for RPE following cardiac surgery. These promising findings warrant confirmation in larger multicenter studies with longer follow-up to establish its long-term efficacy and clinical applicability.

Keywords:
  • Pleural effusion
  • Cardiac surgery
  • Platelet rich plasma
  • Fibrin glue
  • Coronary artery bypass grafting
  • Cardiology
  • Surgery

How to Cite

Moeinipour, Y., Moeinipour, A., Hosseinzadeh Maleki, M., Abbasi Teshnizi, M., Hoseinikhah, H., Naghibi, M., … Hamidi Alamdari, D. (2026). Biological Mechanisms and Therapeutic Potential of PRP-Fibrin Glue in Managing Refractory Pleural Effusion: Insights from a Pilot Study. Archives of Advances in Biosciences, 16(1), 1–9. https://doi.org/10.22037/aab.v16i1.50478

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