SmartPReP®2 APC+®
Autologous Platelet Concentrate+
                                 Procedure Pack
                                 Instructions for Use
                                APC-30 / APC-30i
                                APC-60 / APC-60i
                               APC-120 / APC-120i
Harvest Technologies Corp.                                  Harvest Technologies GmbH.
Suite 100                                                           Zehntfeldstrasse 240a
40 Grissom Road                                                D-81825 Munich, Germany
Plymouth, MA 02360                                               Phone: +49 89 737778-0
1-877-8HARVEST (US ONLY)                                            Fax: +48 89 737778-0
info@harvesttech.com                                                 info@harvesttech.de
                                    www.harvesttech.com
1                                                                     4003044 / 0982
Indications for Use: The SmartPReP2 Procedure Pack is intended for use with the SmartPReP2 Platelet Concentrate System.
Contraindications: The use of the Harvest SmartPReP2 System may be contraindicated when there is clinical or laboratory evidence
of septicemia; and for patients who have taken aspirin, or other medications that alter platelet function within 3 days prior to surgery,
or patients with disorders associated with platelet dysfunction.
Warnings U.S. Only: 1) Federal law (USA) restricts this device to sale by, or on the order of a physician. The physician is solely
responsible for the use of this device; 2) Plasma and platelets prepared with this system are not intended for transfusion.
Precautions: 1) Refer to SmartPReP2 Operator’s Manual for additional information concerning centrifuge operation and
maintenance; warnings and Precautions; 2) Inspect product prior to use, do not use if tray pack is damaged or opened; 3) Always
follow aseptic technique whenever entering a sterile container; wipe ACD-A and PD chamber access sites with alcohol pad prior to
entry; 4) Aseptic technique, proper skin preparation, and continued protection of the venipuncture site are essential; 5) Dispose of
blood contaminated disposable following hospital policy and procedures for biological waste, use Universal cautions; 6) After
processing, maintain PD upright. Tilting may spill fluids from one chamber to the other, affecting process results; 7) Separated blood
products should be used within 4 hours of collection. 8) Do not resterilize, disposable is for single patient use only, discard all unused
components at the end of the procedure; 9) Re-use may lead to infection or illness/injury/death.
                                                    Procedure Pack Components
        APC-30 APC-60 APC-120 Components                                                        APC-30i APC-60i APC-120i
            1          1         1       IV Start Pack                                              -           -            -
            1          1         1       19 G IV Fistula                                            1           1            1
         1-3mL      1-3mL     1-5mL      Anticoagulant Syringe                                   1-3mL       1-3mL        1-5mL
            1          1         1       Blunt Needle(Red)                                          1           1            1
        1-35mL 1-60mL 2-60mL Blood Draw Syringe                                                 1-35mL 1-60mL            2-60mL
            1          1         2       Blunt Needle(Red)                                          1           1            2
            1          1         1       ACD-A Anticoagulant, USP (30mL)                            1           1            1
        1-30mL 1-60mL 2-60mL Process Disposable (PD)                                            1-30mL 1-60mL            2-60mL
        1-20mL 1-30mL 1-30mL Plasma Syringe with Blunt Cannula & Spacer(s)                      1-20mL 1-30mL            1-30mL
        1-10mL 1-20mL 2-20mL Platelet Concentrate Syringe with Blunt Cannula 1-10mL 1-20mL                               2-20mL
            1          1         1       10 mL Syringe (spare)                                      1           1            1
            1          1         2       Blunt Plastic Cannula                                      1           1            2
            1          1         1       Sterile Plastic Cups (3)                                   1           1            1
            1          1         1       Patient Labels Set                                         1           1            1
            -          -         -       Alcohol Pad                                                1           1            2
INSTRUCTIONS FOR USE:
Preparation of the Venipuncture Site:
PRECAUTION:          The health care professional responsible for blood collection should be trained in the practice
                     of venipuncture and the inherent risks. Aseptic technique, proper skin preparation and
                     continued protection of the venipuncture site are essential.
The following steps provide general guidelines for preparing the venipuncture site for blood collection:
    1.Use the safety winged infusion set and IV Start Pack provided or other appropriate venous access (20 gauge or larger) to
      withdraw blood.
NOTE: A suitably large peripheral vein free of lesions should be selected, typically the antecubital or cephalic
      vein. A central venous line may also be used. Use only a 20 gauge or larger IV Fistula.
    2.   Apply tourniquet or blood pressure cuff; identify venipuncture site and release tourniquet/cuff.
    3.   Scrub area at least 4 cm (1.5 inches) in all directions from the intended site of venipuncture for a minimum of 30 seconds
         with either an aqueous solution of iodophor compound or other sterilizing compounds. Excess foam may be removed, but
         the arm need not be dry before the next step.
    4.   Starting at the intended site of venipuncture and moving outward in a concentrical spiral apply “prep” solution; let stand for
         30 seconds or enough time for the skin to dry.
    5.   Cover the area with dry, sterile gauze until the time of venipuncture. After the skin has been prepared, it must not be touched
         again. Do not repalpate the vein at the intended venipuncture site.
    6.   Perform venipuncture, clamp the tube of the IV and secure tubing to skin.
2                                                                                                                      4003044 / 0982
Drawing Patient Blood
NOTE: Patient’s blood should be drawn prior to the start of the procedure and before administration of
       any fluids (particularly systemic anticoagulants).
1. Remove Processing Disposable(s) (PD) from packaging and place on an appropriate workspace.
PRECAUTION: Ensure the shelf in the blood chamber slides up and down freely prior to filling. On rare
                occasions the shelf may become stuck in an upward position due to shifting during
                transportation.     If the shelf is stuck simply tap the bottom of the blood tube enough to
                dislodge the shelf until it floats to the bottom of the blood chamber. If this technique does
                not work, use a sterile syringe to push the shelf until it bottoms out in the blood chamber.
                Only after the shelf is bottomed out in the blood chamber should the operator dispense
                blood into the Process Disposable.
2.   A) Draw the appropriate amount of anticoagualant (ACD-A) into the blood draw syringe per Table 1 and transfer
        ACD-A into the plasma chamber (white port) of the PD. (Fig 1& 2)
                                                 Table 1 – Anticoagulant Dispensing
                                                           Plasma Side    Blood Draw
                                               PD Size        of PD         Syringe
                                                30 ml          1 ml           3 ml
                                                 60 ml          2 ml             6 ml
     B) (Alternate Office Protocol) Draw 4 ml of ACD-A (APC-30) or 8 ml ACD-A (APC-60) into the appropriate blood
        draw syringe. Transfer 1 ml ACD-A from the 35 ml syringe or 2 ml ACD-A from the 60 ml syringe into the plasma
        chamber (white port) of the PD. (Fig 1 & 2)
3.   Connect the blood draw syringe to safety winged infusion set (or alternative access site). Release clamp.
4. Draw blood from the patient (Fig. 3) at a continuous rate that minimizes excessive vacuum pressures, typically no faster than 1cc
   per second. For the 30 ml PD, fill the syringe to the 35 ml mark. For the 60 ml PD, fill the syringe to 60 ml total volume. Do not
   overfill the PD. Close IV access clamp and disconnect the syringe.
PRECAUTION: Excessive force may activate platelets and hemolyze red blood cells.
                   Invert the syringe several times to ensure adequate mixing of the blood and anticoagulant.
PRECAUTION: Inadequate mixing may cause the blood to clot in the syringe and/or may result in
                   suboptimal process results.
5.  Attach a Blunt Needle cannula to the blood filled syringe and dispense contents (at 1cc per second) into the blood chamber of the
    PD through the RED access site (Fig 4 & 5).
PRECAUTION: To avoid dislodging the access site: 1. Be sure the needle tip is in the center of the access site.
                   2. The needle must be straight up (perpendicular). 3. Do not push down on the access site when
                   dispensing blood. Entering off center or on an angle or excessive pressure may dislodge the access site.
Blood Processing
     1.   Load Centrifuge: Place the PD into the SmartPReP2 System. Insert the appropriate reusable Balance Weight into the
          opposite bucket; BW-30 for the 30 ml PD, BW-60 for the 60 ml PD.
     Fig 1
                                                                Fig 3
                         Fig 2                                                            Fig 4                  Fig 5
3                                                                                                                        4003044 / 0982
PRECAUTION: Use appropriate Balance Weight when running one PD. Without Balance Weight, the resulting
            imbalance will shutdown centrifuge.
PRECAUTION: Do not force the PD or BW into Rotor Trunnion. The PD and BW should fit snuggly but should not require
            excessive force to install. If resistance is experienced, check for obstructions in the Rotor and/or debris on the
            PD and/or BW.
                                                                                                            Fig 7
                                         Fig 6
    2.   Close lid on machine, the AMBER “LID OPEN” light must be off. Press GREEN
         “START” button to start the process. Total processing time is approximately 14 minutes.
    3.   Remove PD (s) when cycle is complete. Using the alcohol pad moving in a concentrical spiral wipe the red
         port of the PD prior to entry.
    4.   a) Platelet Resuspension, 30 ml PD: The plasma volume used for platelet resuspension is
           4 mL. Using the plasma syringe with blunt cannula and spacer, withdraw plasma volume
           from plasma chamber of PD (white port) until air enters the syringe. Approximately 4 mL of                  Fig 8
         . plasma and platelet concentrate (PC) will be left in the PD. By first removing the distal
           spacer of the three spacers, 3 ml of plasma and platelet concentrate will remain in PD.
         b) Platelet Resuspension, 60 ml PD: The plasma volume used for platelet resuspension
         . is 10 mL. Using the plasma syringe with blunt cannula and spacer(s), withdraw
            plasma volume from plasma chamber of PD until air enters the syringe. Approximately
            10 mL of plasma and platelet concentrate will be left in the PD. By first removing the smaller
            of the two spacers, 7 ml of plasma and platelet concentrate will remain in the PD.
    5.   Transfer the recovered plasma to the yellow cup located in sterile field (if needed).
    6.   To resuspend the platelets into a concentrated platelet rich plasma (PRP):
             a.   Withdraw remaining plasma into platelet concentrate syringe with blunt needle (NO SPACER) and
                  gently inject back into the plasma chamber.
             b.   Repeat above step 2-3 times (until platelets are visibly resuspended in the plasma) and withdraw total
                  volume into syringe.                                                                                   Fig 9 & 10
             c.Observe base of plasma chamber to confirm all platelets have been withdrawn into platelet concentrate
               syringe.
   7. Transfer platelet rich plasma to the red specimen cup located in sterile field.
NOTE: Always place the blood components in the appropriate sterile plastic colored specimen cup.
PRECAUTION:      Excess blood products should be disposed of in accordance with policies for disposal of
                 biohazardous waste.
US and Foreign Patents Pending. Harvest and SmartPReP are registered trademarks of Harvest Technologies Corporation.
                           Terumo is a registered trademark of Terumo Americas Holding Corporation.
4                                                                                                               4003044 / 0982