US20060278588A1 - Apparatus and method for separating and concentrating fluids containing multiple components - Google Patents

Abstract

An apparatus that allows for separating and collecting a fraction of a sample. The apparatus, when used with a centrifuge, allows for the creation of at least three fractions in the apparatus. It also provides for a new method of extracting the buffy coat phase from a whole blood sample. A buoy system that may include a first buoy portion and a second buoy member operably interconnected may be used to form at least three fractions from a sample during a substantially single centrifugation process. Therefore, the separation of various fractions may be substantially quick and efficient.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS
• This application is a continuation-in-part of U.S. patent application Ser. No. 10/932,882, filed on Sep. 02, 2004, entitled “APPARATUS AND METHOD FOR SEPARATING AND CONCENTRATING FLUIDS CONTAINING MULTIPLE COMPONENTS”, which is a continuation-in-part of U.S. patent application Ser. No. 10/445,381, filed on May 23, 2003, entitled “APPARATUS AND METHOD FOR SEPARATING AND CONCENTRATING FLUIDS CONTAINING MULTIPLE COMPONENTS” that claimed the benefit of U.S. Provisional Application No. 60/383,013, filed on May 24, 2002. The disclosures of the above applications are incorporated herein by reference.
FIELD
• The present teachings relate to a multiple component fluid and a concentrator/separator and, more particularly, relates to a container operable with a centrifuge to separate and/or concentrate various biological components.
BACKGROUND
• Various fluids, such as whole blood or various other biological fluids, may be separated into their constituent parts, also referred to as fractions or phases. For example, whole blood samples may include a plurality of constituents that may be separated by density in a device such as a centrifuge. The whole blood sample may be placed in a test tube, or other similar device, which is then spun in a centrifuge. In the centrifuge the whole blood is separated into different fractions depending upon the density of that fraction. The centrifugal force separates the blood or other sample into different fractions. In addition, various elements may be added to the test tube to create more than two fractions. In particular, commonly used gels may be used to divide the whole blood into a plurality of different fractions which may include fractions such as platelets, red blood cells, and plasma. Various other biological fluids may be separated as well. For example, nucleated cells may be separated and extracted from bone marrow or adipose tissue sample.
• Many of these systems, however, do not provide a simple or efficient method to extract any more than one fraction and, especially, a fraction other than the top fraction. The top fraction of whole blood is plasma, or other blood constituents suspended in plasma. Thus, to extract other fractions the plasma fraction must either be removed for further extracting procedures or spun again to obtain the constituents suspended in this plasma. It is difficult to pierce the top fraction without commingling the sample. Accordingly, obtaining the other fractions is difficult with commonly known systems.
• Other systems have attempted to alleviate this problem by providing a float or other device that is disposed within the sample at the interfaces of the different fractions during the centrifuge process. Nevertheless, these systems still do not allow a simple way to remove the different fractions without remixing the sample fractions. In addition, many of the systems do not allow an easy and reproducible method to remove the desired sample fraction.
• Therefore, it is desired to provide a device to allow for the easy and reproducible removal of a particular fraction which does not happen to be the top fraction of a sample. It is desired to remove the required sample without mixing the different fractions during the extraction process. In addition, it is desired to provide a device which allows for a consistent extraction which includes known volumes or concentration of the fraction elements. Moreover, it is desired to separate and concentrate a selected fraction with one centrifugation step.
SUMMARY
• The present teachings provide an apparatus that separates and concentrates a selected fraction or component of a fluid, such as a biological fluid. For example, undifferentiated cells, such as mesenchymal stem cells, platelet fraction, buffy coat, or white blood cell fraction can be separated from bone reaming material, whole blood, bone marrow aspirate, and other materials. In various embodiments, the apparatus, when used with a centrifuge, is generally able to create at least two fractions. The present teachings also provide for a new method of creating at least three fractions extracting a third fraction from a sample such as, for example, a buffy coat fraction.
• In various embodiments, the apparatus includes a container to be placed in a centrifuge after being filled with a sample and the container includes a buoy or fraction separator having a selected density that may be less than one fraction but greater than a second fraction, that is disposed therein. In various embodiments, a second buoy may be placed in the container with the first. The extraction system is connected to the buoy system or to the collection chamber such that the fraction in the container can be collected and drawn outside of the chamber. During the centrifuge processing, the buoy is forced away from a bottom of the container as the denser fraction collects at the bottom of the container. The buoy is generally able to physically separate the denser fraction from another fraction of the sample. In various embodiments, the fractions can be withdrawn using an extraction system.
• According to various embodiments, in addition to providing a first buoy and/or a second buoy, a buoy system may be provided. Generally, the buoy system may separate the sample into at least three fractions. The fractions may be separated and extracted from the container without substantially commingling the various fractions. Generally, a first buoy and a second buoy operate together to separate the sample into the various fractions and a syringe or tube may then be interconnected with a portion of the buoy system to extract the selected fractions. For example, a first buoy may be tuned to a density less than the density of a red blood cell fraction of a whole blood sample, bone marrow aspirate sample, or combinations thereof, and a second buoy may be tuned to a density less than the density of a buffy coat fraction.
• According to various embodiments, a method of forming an enriched scaffold for application relative to an anatomy is provided. The method may include obtaining a volume of a first whole material and obtaining a volume of a second whole material. A first fraction of the first whole material and a second fraction of the second whole material may be formed. At least one of the first fraction or the second fraction may be applied to the scaffold and at least one fraction for application relative to an anatomy is provided. The method may include obtaining a volume of heterogeneous whole material and separating the material into the desired fraction(s). At least one of the fractions may be applied to the scaffold.
• According to various embodiments, a method of withdrawing a material directly from a patient and collecting a selected fraction of the material in a container is provided. The method may include forming an access to port to the patient. A pressure differential in a collection container may be formed relative to the patient. A connection may be made between the patient and the collection container via the port. The collection container may be filled with the material and then the material may be separated to form the selected fraction.
• According to various embodiments, a method for concentrating bone aspirate can include obtaining a volume of bone marrow aspirate from a mammal and loading the volume bone marrow aspirate into a separator, the separator operable to separate the aspirate into three of more fractions. The method also includes centrifuging the separator to create a fraction that is a concentrated bone marrow aspirate and extracting and removing the fraction from the separator.
• According to various embodiments, a method for concentrating bone marrow aspirate and blood includes collecting bone marrow aspirate and blood from a patient then loading the bone marrow aspirate and blood into a separator that can separate the aspirate and the blood into three or more fractions. The method includes centrifuging the separator containing the bone marrow aspirate and the blood creating a fraction that has a concentrated bone marrow aspirate and a concentrated blood. In various embodiments, such a concentration may be referred to as a buffy coat. The method also include withdrawing the fraction comprising the concentrate or buffy coat.
• According to various embodiments, a method for treating a defect in a mammal using a concentrated bone marrow aspirate includes drawing bone marrow aspirate from the mammal and loading the bone marrow aspirate into a separator that can separate the bone marrow aspirate into three or more fractions. The method includes centrifuging the separator separating the bone marrow aspirate into fractions and one fraction is concentrated bone marrow aspirate. The method also can include the concentrated bone marrow aspirate and applying the bone marrow aspirate to a site of a defect in the mammal.
• According to various embodiments, a method for treating a defect in a patient includes drawing bone marrow aspirate and whole blood from the patient then adding anticoagulants to the bone marrow aspirate and the blood. The method includes the loading of the bone marrow aspirate and the blood into a separator that can separate the bone marrow aspirate and blood into three or more fractions. The method also includes centrifuging the separator then withdrawing a fraction comprising at least one of the group consisting of hematopoietic stem cells, stromal stem cells, mesenchymal stem cells, endothelial progenitor cells, red blood cells, white blood cells, fibroblasts, reticulacytes, adipose cells, and endothelial cells, then applying the fraction to the site of the defect in the patient.
• According to various embodiments, a method of treating a patient with a combination of concentrated bone marrow aspirate and buffy coat is provided. The method includes obtaining blood and bone marrow aspirate from the patient, forming a buffy coat fraction of the whole blood and forming a concentrated bone marrow aspirate fraction, and applying at least one of the buffy coat or concentrated bone marrow aspirates to the patient.
• Further areas of applicability of the present teachings will become apparent from the detailed description provided hereinafter. It should be understood that the detailed description and specific examples, while indicating various embodiment of the teachings, are intended for purposes of illustration only and are not intended to limit the scope of the teachings.
BRIEF DESCRIPTION OF THE DRAWINGS
• The present teachings will become more fully understood from the detailed description and the accompanying drawings, wherein:
• FIG. 1 is a plan view of a separator including a depth gage affixed to a plunger in a tube according to various embodiments of the present teachings;
• FIG. 2 is a cross-section view taken along line2-2 ofFIG. 1;
• FIG. 3 is an exploded of the separator apparatus according to various embodiments;
• FIG. 4 is a kit including the separator according to an embodiment of the present teachings;
• FIG. 5A is a plan view of the separator, according to various embodiments, being filled;
• FIG. 5B is a plan view of a blood sample in the separator after the centrifuge process;
• FIG. 5C is a plan view of the plunger plunged into the tube with the depth gage to further separate the blood sample;
• FIG. 5D is a plan view of the buffy coat and the plasma fractions being extracted from the separator according to various embodiments;
• FIG. 6A is a side plan view of a buoy system according to various embodiments;
• FIG. 6B is a cross-sectional view of the buoy system ofFIG. 6a;
• FIG. 7A is a plan view of a separator, according to various embodiments, being filled;
• FIG. 7B is a plan view of a separator, according to various embodiments, after a centrifugation process;
• FIG. 7C is a plan view of a separator system, according to various embodiments, being used to extract a selected fraction after the centrifugation process;
• FIG. 7D is a plan view of a second fraction being extracted from the separator according to various embodiments;
• FIG. 8 is a schematic view illustrating an assisted blood withdrawal device according to various embodiments; and
• FIG. 9 is a block diagram illustrating a method for applying selected fractions of a fluid.
DETAILED DESCRIPTION OF VARIOUS EMBODIMENTS
• The following description of various embodiments is merely exemplary in nature and is in no way intended to limit the teachings, its application, or uses. Although the following description exemplary refers to a bone reaming material, whole blood and/or bone marrow aspirate separation, it will be understood that the present teachings may be used to separate and concentrate any appropriate material. It will be further understood that many multi-component materials containing particles may be separated. The components or fractions are generally intermingled in the whole sample but may be separated with a centrifuge device that causes increased local gravity or gravitational forces.
• With reference toFIGS. 1-3, according to various embodiments, aseparator10, also referred to as a concentrator, is illustrated. Theseparator10 generally includes a tube orcontainer12 that is adapted to hold a fluid sample, such as an anti-coagulated whole blood sample, for further processing. It will be understood that thetube12 may hold other solutions including constituents of more than one density, such as bone marrow or a mixture of whole blood and bone marrow. Thetube12 includes a top oropen end12a, which is closeable, and a bottom orclosed end12b. The bottom12bmay also be selectively closeable.
• Disposed within thetube12 is a first piston or buoy14 that is able to move along a central axis A of thetube12. Thebuoy14 is generally nearer thebottom end12bof thetube12 rather than theopen end12a. Thebuoy14 is able to move along a central axis A oftube12. Also disposed within thetube12 is a second piston orplunger16. Theplunger16 is also able to move within thetube12 generally between a position closer to theopen end12ato a position closer to theclosed end12bof thetube12. Acap18 substantially mates with theopen end12aof thetube12 to close thetube12 save for ports formed in thecap18. Extending from thecap18 is a plasma valve orport20 that communicates with an area, described further herein, within thetube12 defined between theplunger16 and thecap18. It will be understood that theplasma port20 is merely exemplary in nature and simply allows for removal of a selected fraction of a sample such as, for example, plasma from whole blood.
• Thecap18 also includes adepth gage port19. Extending from theplunger16 and through thedepth gage port19 is afirst plunger port22. A depth guide orgage24 includes afemale connector26 adapted to connect with thefirst plunger port22. Thedepth gage24 also includes a depth gage housing orcannula28. Thedepth gage housing28 defines a depth gage bore30. Incorporated in thedepth gage housing28 and extending distal from the end mating with theplunger16 is aneck32. Theneck32 includesexternal neck threads34. Theexternal neck threads34 are adapted to engage appropriate internal threads of a mating member.
• The mating member may include acompression nut36 that mates with theexternal neck threads34 to lock adepth gage rod38 in a predetermined position. Asplit bushing39 is also provided to substantially seal thedepth gage housing28 when thedepth gage rod38 is locked in place. Thedepth gage rod38 extends through thedepth gage housing28 and terminates at arod handle40. The rod handle40 may be a form easily manipulated by a human operator. Thedepth gage rod38 extends coaxially with axis A of thetube12. Thedepth gage rod38 extends through the plunger16 a predetermined distance and may be locked at that distance with thecompression nut36.
• Although thetube12 is described herein as a cylinder, it will be understood that other shapes may be used, such as polygons. The internal portions, such as thecap18,buoy14, andplunger16, would also include this alternate shape. Preferably thetube12 is formed of a thermal plastic material which is flexible under the forces required to separate blood. Thetube12 may be made of a material that includes the properties of both lipid and alcohol resistance. These properties helps increase the separation speed and decrease the amount of material which may cling to thetube wall42. For example, Cyrolite MED2® produced by Cyro Industries of Rockaway, N.J., may be used to produce thetube12.
• Thetube12 has atube wall42 with a thickness of between about 0.01 millimeters and about 30.0 millimeters, although thetube wall42 may be any appropriate thickness. The thickness of thetube wall42 allows thetube wall42 to flex during the centrifuge process yet be rigid enough for further processing of a blood sample disposed in thetube12. Thetube12 is closed at thebottom end12bwith a tube bottom44 formed of the same material as thetube wall42 and is formed integrally therewith. Generally, the tube bottom44 has a thickness which is substantially rigid under the forces required to separate the sample such that it does not flex.
• Thebuoy14 includes an upper or collection face46 that defines an inverse cone or concave surface. Generally, the cone has an angle of between about 0.5° to about 45°, and may be about 0.5° to about 90° from a vertical axis, wherein the apex of the cone is within thebuoy14. The collection face46 forms a depression in thebuoy14 which collects and concentrates material during the separation process. Additionally, thebuoy14 has abottom face48 that defines an inverse cone, dome, or covered surface. Thebuoy bottom face48 includes an apex50 that engages the tube bottom44 before abuoy edge52 engages thetube bottom44. Thebuoy14 includes a material that is a substantially rigid such that the buoy edges52 never meet thetube bottom44. Therefore, there is a gap orfree space54 formed between the buoy edges52 and the tube bottom44 along the perimeter of thebuoy14.
• Theseparator10 is generally provided to separate a multi-component fluid that generally includes various components or constituents of varying densities that are commingled or mixed together. Theseparator10 includes thebuoy14 that is of a selected density depending upon a selected constituent of the multi-constituent liquid. Although thebuoy14 may be tuned or of any selected density, the following example relates to separation of whole blood to various components. Therefore, thebuoy14 will be discussed to include a selected density relative to whole blood separation. It will be understood, however, that thebuoy14 may be of any appropriate density depending upon the multi-component fluid being separated including, for example, the concentrating of bone marrow aspirate.
• Thebuoy14 may be formed of any appropriate material that may have a selected density. For example, when theseparator10 is to separate blood, thebuoy14 generally has a density which is greater than that of red blood cells in a whole blood sample, but less than the plasma or non-red blood cell fraction of a whole blood sample. For blood, the density of thebuoy14 may be between about 1.00 g/cc to about 1.12 g/cc or between about 1.02 g/cc and about 1.09 g/cc.
• To achieve the selected density, thebuoy14 may be formed as a composite or multi-piece construction, including a plurality of materials. Particularly, a first oroutside portion56 defines the upper orcollection face46 and the buoy edges52 and is formed of the same material as thetube12. Theoutside portion56 defines a cup or void into which a plug or insert58 is placed. Theinsert58 has a mass such that the density of theentire buoy14 is within the selected range, for example, the range described above. Generally, a high density polyethylene may be used, but the material and size of theinsert58 may be altered to produce the desired density of thebuoy14. Alternatively, thebuoy14 may be formed of a single suitable material that has a density in the selected range. Nevertheless, thebuoy14 formed unitarily or of a single material would still include the other portions described in conjunction with thebuoy14.
• Theoutside portion56 of thebuoy14 also defines the outside circumference of thebuoy14. The outside circumference of thebuoy14 is very close to the internal circumference of thetube12. Due to the operation of thebuoy14, however, described further herein, there is a slight gap between the outside of thebuoy14 and the inside of thetube12. Generally, this gap is between about 1 and about 10 thousandths of an inch around the entire circumference of thebuoy14. Generally, it is desired that the distance between the outside circumference of thebuoy14 and the inside circumference of thetube12 is great enough to allow a selected material or component to pass. For example, in whole blood the distance is selected so that red blood cells may pass through the gap without being lysed, damaged, or activated.
• Theplunger16 includes a plunger front orcollection face60 and aplunger wall62 that extends from theplunger front face60. Theplunger wall62 extends relatively perpendicular to theplunger front face60 and substantially parallel to thetube wall42. Extending from the center of theplunger16 is asample collection projection64. Extending from the top of thesample collection projection64 is thefirst plunger port22. Thesample collection projection64 includes a plunger sample collection bore68 defined therethrough. The plunger sample collection bore68 terminates at asample collection aperture70 that is substantially in the center of theplunger front face60. Theplunger front face60 also defines an inverse cone where thesample collection aperture70 is the apex of the cone. Theplunger front face60 defines a cone with an angle substantially similar or complimentary to thecollection face46 of thebuoy14. In this way, theplunger front face60 may mate substantially completely with thecollection face46 for reasons described more fully herein.
• Theplunger16 also includes aback face72. Extending from theplunger front face60 to theback face72 is abore74. Acheck valve76 is operably connected to thebore74. Thecheck valve76 allows a liquid to move from theplunger front face60 to theback face72 while not allowing the liquid to move from theback face72 to theplunger front face60. Therefore, thecheck valve76 is substantially a one-way valve which allows a material to move in only one direction. Thecheck valve76 may also operate automatically allowing flow in only one predetermined direction. Alternatively, thecheck valve76 may be operated manually and include a portion extending from thecheck valve76 requiring manipulation to stop or start a flow through thecheck valve76.
• Theplunger16 may be made out of any appropriate material which does not interfere with the separation of the fractions of the fluid, such as whole blood. Theplunger16, however, is made of a material that is flexible or at least partially deformable. A flexible material allows theplunger16 to have an external circumference defined by theplunger walls62 that is substantially equal to the internal circumference of thetube12. Because of the deformability of theplunger16, however, theplunger16 is still able to move within thetube12. Theplunger16 is able to move through thetube12 and also substantially wipe the interior of thetube wall42. This creates, generally, a moveable seal within thetube12. Thus, substantially no material escapes the action of theseparator10 when theplunger16 is plunged into thetube12. This also helps concentrate the portion of the sample desired to be collected, described more fully herein.
• Thecap18 provides a structure to substantially close thetube12. Thecap18 particularly includes aplate78 that has an external circumference substantially equal to the external circumference of thetube12. Extending from theplate78 and into thetube12 is aflange80. The external circumference of theflange80 is substantially equal to the internal circumference of thetube12. In this way, thecap18 substantially closes thetube12. It will be understood thecap18 may be in any form so long as thecap18 substantially closes and/or seals thetube12 when installed.
• Formed through the center of theplate78 is thedepth gage port19. Thedepth gage port19 is also adapted to receive thesample collection projection64. Thefirst plunger port22 extends above theplate78 through thedepth gage port19. The circumference of thedepth gage port19 is substantially equal to the external circumference of thesample collection projection64 such that a liquid seal is formed. Theplate78 defines asample face84 that includes an interior side of thecap18. The area between thesample face84 of thecap18 and theback face72 of theplunger16 define aplasma collection area86. Although theplasma collection area86 is exemplary called the plasma collection area, it will be understood that theplasma collection area86 may also collect any appropriate fraction of the sample that is positioned within aseparator10. Theplasma collection area86 is merely an exemplary name and an example of what material may be collected in the area of theseparator10. As discussed herein, theseparator10 may used to separate whole blood into various fractions, therefore, theplasma collection area86 is used to collect plasma. Theplasma collection area86 also allows a space for thecheck valve76 to be installed.
• Asecond bore88 is formed in theplate78. Extending through thesecond bore88 is theplasma collection valve20. In liquid communication with theplasma collection valve20 is aplasma collection tube92. Theplasma collection tube92 has a length such that theplasma collection tube92 is able to extend from theplasma collection valve20 to substantially thetube bottom44. Theplasma collection tube92, however, is flexible enough such that it may be folded or compressed to fit within theplasma collection area86 when theplunger16 is substantially near theopen end12aof thetube12. Theplasma collection tube92 may also be connected to ahose barb93 that includes a plasma collection bore93a. The plasma collection bore93ais substantially level with the plunger backface72. Alternatively, the plasma collection bore93amay be positioned below the plunger back face72 but in fluid communication with theplasma collection tube92.
• The outboard side of theplasma collection valve20 may include external threads94 to mate with internal threads of aplasma valve cap96. Therefore, theplasma collection valve20 may be selectively opened and closed via theplasma valve cap96. It will be understood, however, that other appropriate means may be used to open and close theplasma collection valve20 such as a clip or a plug. It will be understood that theplasma collection valve20,plasma collection tube92, plasma collection bore23amay be used to collect any appropriate material or fraction from theseparator10.
• Also formed in theplate78 is a vent bore98. The vent bore98 allows air to flow into theplasma collection area86 as theplunger16 is being plunged into thetube12. The vent bore98 may include afilter100 such that liquid cannot escape from thetube12. Thefilter100 allows air to enter or escape from theplasma collection area86 while maintaining the liquid seal of thetube12 produced by thecap18.
• Selectively attachable to thefirst plunger port22 is thedepth gage24. Thefemale connector26 interconnects thedepth gage housing28 to thefirst plunger port22. Internal threads in thefemale connector26 mate with anexternal thread102 formed on thefirst plunger port22. It will be understood, however, that other engagement mechanisms between thedepth gage24 and theplunger16 may be used. For example, a snap connection rather than a threaded connection between the two may be used.
• Thedepth gage housing28 is formed to be substantially rigid. Suitable materials, when sized properly, include polycarbonate and CYRO MED2®. The material preferably is both rigid and does not substantially react with the sample. It is rigid enough to provide a mechanism to plunge theplunger16 into thetube12. In addition, the external circumference of thedepth gage housing28 is substantially equal to the circumference of thedepth gage port19 in theplate78. Therefore, as theplunger16 is being plunged into thetube12 with thedepth gage24, no liquid material is allowed to escape around thedepth gage housing28 and throughdepth gage port19.
• Formed within thedepth gage housing28 is thebore30 which receives thedepth gage rod38. Thedepth gage rod38 extends through the plunger sample collection bore68 of thesample collection projection64 and protrudes through the sample collection aperture70 a predetermined length. Thedepth gage rod38 extends through the sample collection aperture70 a length such that when anend104 of thedepth gage rod38 meets thebuoy14, the volume defined by thecollection face46 and theplunger front face60 is between about 5% and about 30% of the total volume of the sample that thetube12 holds. The projection of thedepth gage rod38 allows for an easily reproducible collection amount and concentration over several trials.
• Thecompression nut36 locks thedepth gage rod38 in the predetermined position. Nevertheless, once theplunger16 has been plunged to the desired depth in thetube12, thecompression nut36 may be loosened so that thedepth gage rod38 may be removed from theplunger16 and thedepth gage housing28 without moving theplunger16. A syringe or other appropriate device may then be affixed to theexternal neck threads34 of thedepth gage24 to extract the fraction or phase that is between theplunger front face60 and thecollection face46. As described further herein, the fraction or phase that is left between theplunger front face60 and thecollection face46 may be the buffy coat of a whole blood sample. Nevertheless, it will be understood that the fraction between theplunger front face60 and thecollection face46 may be any appropriate fraction of the sample that is disposed in theseparator10.
• Theseparator10 may be provided alone or in akit200, as illustrated inFIG. 4. Thekit200 may be placed in atray202 which is covered to provide a clean or sterile environment for the contents of thekit200. Thekit200 may include at least afirst separator10 and asecond separator10′. Afirst depth gage24 and asecond depth gage24′ are also provided, one for eachseparator10,10′. Thekit200 also generally includes afirst syringe204, including a needle, to draw a biological sample, such as blood from a patient. Thefirst syringe204 may also be used to place the sample in thefirst separator10. After centrifuging the sample a second device orsyringe210 may be used to extract a first fraction of the sample, while a third device orsyringe212 may be used to extract a second fraction of the sample. Also, atourniquet214 and other medical supplies, such asgauze216 andtape218, may be provided to assist the practitioner. It will be understood the elements of thekit200 are merely exemplary and other appropriate items or elements may be included.
• With reference toFIGS. 5A-5D, a method using theseparator10 is illustrated according to various embodiments. The following example relates specifically to the taking and separating of a sample of whole blood from a patient. Nevertheless, it will be understood that another appropriate biological material may be separated and concentrated using theseparator10. For example, bone marrow may be separated and concentrated using theseparator10. The various fractions of the bone marrow are similar to the fractions of whole blood. Generally, the bone marrow includes a fraction that includes substantially dense material and a second phase that is less dense and has other components suspended therein such as, for example, nucleated cells. The bone marrow sample may be positioned in theseparator10, similarly to the whole blood as described herein, and separated in a substantially similar manner as the whole blood. Theseparator10 can then be used to remove nucleated cells from the bone marrow sample (which may be referred to as buffy coat), whereas theseparator10, as described herein, is used to remove the buffy coat from the whole blood which includes platelets and other appropriate materials (which may be referred to as platelet rich plasma (PRP)).
• A mixture of whole blood and bone marrow may be positioned in theseparator10 for separation and concentration. Similar methods and steps will be used to separate the mixture of whole blood and bone marrow with a main difference being the material that is separated. It will also be understood that various centrifuge times or forces may be altered depending upon the exact material that is being separated with theseparator10. It will also be understood that the separation of whole blood, bone marrow, or a mixture of whole blood and bone marrow are merely exemplary of the materials that may be separated using theseparator10.
• According to various embodiments, and with reference toFIGS. 5A-5D and to a whole blood sample, a sample of whole blood taken from a patient is placed in thetube12 with an anticoagulant using thefirst syringe204 or other appropriate delivery method. In particular, thefirst syringe204 may be connected to thefirst plunger port22. After which the blood sample is provided to thetube12 via the sample collection bore68 andsample collection aperture70. Acap220 is then placed over thefirst plunger port22 to substantially seal thetube12.
• After the whole blood sample is delivered to thetube12, theseparator10 is placed in a centrifuge. Thesecond separator10′, substantially identical to the first, is placed opposite thefirst separator10 including the sample in a centrifuge. Thesecond separator10′ may also include a second sample or may include a blank, such as water, so that the centrifuge is balanced. Thesecond separator10′ balances the centrifuge by both weight and dynamics.
• Theseparator10 is then spun in the centrifuge in a range between about 1,000 and about 8,000 RPM. This produces a force between about 65 and about 4500 times greater than the force of normal gravity, as generally calculated in the art, on theseparator10 and the blood sample placed in theseparator10. At this force, the more dense material in a whole blood sample is forced toward thebottom end12bof thetube12. The dense material, such as red blood cells or a redblood cell fraction222, collects on thetube bottom44. Because thebuoy14 has a density that is less than the redblood cell fraction222, it is forced in a direction toward thetop end12aof thetube12 in the centrifuge. Nevertheless, because thebuoy14 is denser than aplasma fraction224, thebuoy14 does not reach thetop end12aof thetube12.
• The forces also affect thetube wall42. The forces compress thetube12 linearly along axis A thereby bowing or flexing thetube wall42. As thetube wall42 compresses it increases the diameter of thetube12 making it easier for thebuoy14 to move in the direction of the top12aof thetube12. In addition, thebottom face48, defining an inverse cone, helps the initial movement of thebuoy14. Because thebuoy14 is not substantially flat along its bottom, it does not form a vacuum interaction with thetube bottom44. Therefore, the initial movement of thebuoy14 away from the tube bottom44 is quicker than if the bottom of thebuoy14 was flat.
• During the centrifuge process, the red bloods cells of the redblood cell fraction222 force thebuoy14 in the direction of thetop end12aof thetube12 because thebuoy14 is less dense than the redblood cell fraction222. Although the whole blood sample, including the red blood cells, is loaded above thebuoy14, the red blood cells are able to move between thebuoy14 and thetube wall42 because the circumference of thebuoy14 is less than the internal circumference of thetube12. During the centrifuge process, thebuoy14 stops at an interface of aplasma fraction224 and the redblood cell fraction222 because of the selected or tuned density of thebuoy14.
• With particular reference toFIG. 5B, the centrifuge process has been completed and thebuoy14 has moved to the interface of the redblood cell fraction222 andplasma fraction224. After the centrifuge has slowed or stopped, and before or after thetube12 has been removed from the centrifuge, thetube wall42 decompresses which helps support thebuoy14 at the interface position. It is also understood that applying an external pressure to thetube12 via fingers or another apparatus may help stabilize thebuoy14 during the plunging procedure described herein.
• On ornear collection face46 is amiddle fraction226, including a small, yet concentrated, amount of red blood cells, white blood cells, platelets, and a substantial portion of a buffy coat of the blood sample. Although the plasma is also present near thecollection face46 at this point, the solid portions of the buffy coat are more compressed against thecollection face46. The position of thebuoy14 also helps in this matter. Because thebuoy14 is a single body it defines the interface of theplasma fraction224 and the redblood cell fraction222. Also the density of thebuoy14 assures that it has not passed into theplasma fraction224. Therefore, the fractions remain separated after the centrifuge process. In addition because thebuoy14 is tuned to the density of the redblood cell fraction222, it is not affected by variations in the density of theplasma fraction224 and the buoy's14 position is always at the interface of the redblood cell fraction222 and theplasma fraction224.
• With particular reference toFIG. 5C, thedepth gage24 is affixed to thefirst plunger port22 of thesample collection projection64. After connecting thedepth gage24 to thefirst plunger port22, theplunger16 is plunged into thetube12 by pushing on thedepth gage24. As this is performed theplasma fraction224, formed and separated above thebuoy14, is able to flow through thecheck valve76 into theplasma collection area86. This displacement of theplasma fraction224 allows theplunger16 to be plunged into thetube12 containing the blood sample.
• Theplunger16 is plunged into thetube12 until the point where theend104 of thedepth gage rod38 reaches thebuoy14. The volume left in thecollection face46 is themiddle fraction226 and is determined by thedepth gage24. It may be adjusted by selectively determining the amount that thedepth gage rod38 extends below theplunger front face60. By adjusting thedepth gage24, the concentration of themiddle fraction226 can be adjusted depending upon the desires of the operator.
• Theplasma fraction224 is held in theplasma collection area86 for later withdrawal. Therefore, the use of theplunger16 and thebuoy14 creates three distinct fractions that may be removed from thetube12 after only one spin procedure. The fractions include the redblood cell fraction222, held between thebuoy14 and thetube bottom44. The middle orbuffy coat fraction226 is held between theplunger16 and thebuoy14. Finally, theplasma fraction224 is collected in theplasma collection area86. In various embodiments, themiddle fraction226 may be a platelet rich plasma (PRP) fraction and theplasma fraction224 may be a platelet poor plasma (PPP) fraction.
• Themiddle fraction226 may be extracted from thetube12 first, without commingling the other fractions, through the sample collection bore68. With particular reference toFIG. 5D, thedepth gage rod38 may be removed from thedepth gage housing28. This creates a sample collection cannula which includes the depth gage bore30, the sample collection bore68, and thesample collection aperture70. After thedepth gage rod38 has been removed, thesecond syringe210 may be affixed to thedepth gage housing28 via theexternal neck threads34. Thesecond syringe210 may be substantially similar to thefirst syringe204.
• Before attempting to withdraw themiddle fraction226 theseparator10 may be agitated to re-suspend of the platelets and concentrated red blood cells in a portion of the plasma remaining in thecollection face46. This allows for easier and more complete removal of themiddle fraction226 because it is suspended rather than compressed against thecollection face46. A vacuum is then created in thesecond syringe210 by pulling back theplunger16 to draw themiddle fraction226 into thesecond syringe210.
• As themiddle fraction226 is drawn into thesecond syringe210 theplunger16 moves toward thebuoy14. This action is allowed because of the vent bore98 formed in thecap18. Atmospheric air is transferred to theplasma collection area86 through the vent bore98 to allow themiddle fraction226 to be removed. This also allows the movement of theplunger16 toward thebuoy14. This action also allows theplunger16 to “wipe” thecollection face46. As theplunger front face60 mates with thecollection area46 themiddle fraction226 is pushed into thesample collection aperture70. This ensures that substantially the entiremiddle fraction226 collected in thecollection area46 is removed into thesecond syringe210. It can also increase the repeatability of the collection volumes. In addition, because thesecond syringe210 does not protrude out thesample collection aperture70, it does not interfere with the collection of themiddle fraction226. Once theplunger front face60 has mated with thecollection face46 there is substantially no volume between theplunger16 and thebuoy14.
• Once themiddle fraction226 is extracted thesecond syringe210 is removed from thefirst plunger port22. Also the extraction of themiddle fraction226 leaves theplasma fraction224 and the redblood cell fractions222 separated in thetube12. At this point, athird syringe212 may be affixed to theplasma collection valve20. Thethird syringe212 is connected to the external threads94 of theplasma collection valve20 to ensure a liquid tight connection. It will be understood, however, that another connection mechanism such as a snap or compression engagement may be used to connect thethird syringe212 to theplasma collection valve20.
• A vacuum is then created in thethird syringe212 to draw theplasma fraction224 from theplasma collection area86 through theplasma collection tube92. As discussed above, theplasma collection tube92 is connected to thehose barb93. Therefore, the plasma flows through the plasma collection bore93athrough thehose barb93, and then through theplasma collection tube92. It will be understood that theplasma collection tube92 may alternatively simply rest on the plunger back face72 to collect theplasma fraction224. In this way, theplasma fraction224 may be removed from theblood separator10 without commingling it with the redblood cell fraction222. After theplasma fraction224 is removed, theseparator10 may be dismantled to remove the redblood cell fraction222. Alternatively, theseparator10 may be discarded in an appropriate manner while retaining the redblood cell fraction222.
• Theseparator10 allows for the collection of three of a whole blood sample's fractions with only one centrifugation spin. The interaction of thebuoy14 and theplunger16 allows a collection of at least 40% of the available buffy coat in the whole blood sample after a centrifuge processing time of about 5 minutes to about 15 minutes. The complimentary geometry of theplunger front face60 and thecollection face46 help increase the collection efficiency. Although only the cone geometry is discussed herein, it will be understood that various other geometries may be used with similar results.
• Theplunger front face60 being flexible also helps ensure a complete mating with thecollection face46. This, in turn, helps ensure that substantially the entire volume between the two is evacuated. The process first begins with the suction withdrawal of themiddle fraction226 via thesecond syringe210, but is completed with a fluid force action of themiddle fraction226 as theplunger front face60 mates with thecollection face46. As theplunger front face60 mates with thecollection face46, the fluid force assists in removal of the selected fraction.
• Theplunger16 also substantially wipes thetube wall42. Because theplunger16 is formed of a flexible material it forms a seal with thetube wall42 which is movable. Therefore, substantially no liquid is able to move between theplunger wall62 and thetube wall42. Material is substantially only able to go past theplunger front face60 via thecheck valve76.
• The complimentary geometry also helps decrease the collection time of themiddle fraction226. Therefore, entire time to prepare and remove themiddle fraction226 is generally about5 to about40 minutes. This efficiency is also assisted by the fact that theseparator10 allows for the removal of themiddle fraction226 without first removing theplasma fraction224, which includes the buffy coat, and re-spinning theplasma fraction224. Rather, one spin in theseparator10 with the whole blood sample allows for the separation of the buffy coat for easy extraction through theplunger16.
• As discussed above, theseparator10 may be used to separate any appropriate multi-component material. For example, a bone marrow sample may be placed in theseparator10 to be centrifuged and separated using theseparator10. The bone marrow sample may include several fractions or components that are similar to whole blood fractions or may differ therefrom. Therefore, thebuoy14 may be altered to include a selected density that is dependent upon a density of a selected fraction of the bone marrow. The bone marrow may include a selected fraction that has a different density than another fraction and thebuoy14 may be designed to move to an interface between the two fractions to allow for a physical separation thereof. Similar to the whole blood fraction, theplunger16 may then be moved to near acollection face46 of thebuoy14. The fraction that is then defined by thecollection face46 and theplunger16 may be withdrawn, as described for the removal of the buffy coat from the whole blood sample. For example, themiddle fraction226 in the bone marrow sample may include a fraction of undifferentiated or stem cells. In various embodiments, themiddle fraction226 in a bone marrow sample may include hematopoietic, stem cells, stromal stem cells, mesenchymal stem cells, endothelial progenitor cells, red blood cells, white blood cells, fibroblasts, reticulacytes, adipose cells, or endothelial cells. In various embodiments, themiddle fraction226 is concentrated bone marrow aspirate.
• It will also be understood that mixtures of various fluids may be separated in theseparator10. For example, a mixture of whole blood and bone marrow may be positioned in theseparator10 at a single time. Thebuoy14 may be tuned to move to an interface that will allow for easy removal of both the buffy coat, from the whole blood sample, and the undifferentiated cells, from the bone marrow sample. Nevertheless, it will be understood that theseparator10 may be used within any appropriate biological material or other material having multiple fractions or components therein. Simply, thebuoy14 may be tuned to the appropriate density and theplunger16 may be used to cooperate with thebuoy14 to remove a selected fraction.
• According to various embodiments and with reference toFIGS. 6A and 6B, abuoy system300 is illustrated. Thebuoy system300 generally includes a first buoy orfraction separator member302 and a second buoy member orfraction separator304. Thefirst buoy302 and thesecond buoy304 may be operably interconnected with a buoy system cylinder ormember306. Thebuoy system300 may be placed in a tube, such as thetube12. Thetube12 may be formed of any appropriate material, such as theCryolite Med®2 as discussed above. Nevertheless, thebuoy system300 may be designed to fit in thetube12 or may be formed to fit in any appropriate member that may be disposed within a selected centrifuging device. It will be understood that the following discussion relating to buoysystem300 to be substantially matched to the size of thetube12 is merely exemplary. As thebuoy14 may be sized to fit in any appropriate tube, thebuoy system300 may also be sized to fit in any appropriate tube. It will be further understood that thetube12 may be any appropriate shape. Thetube12 need not only be cylindrical but may also be or include conical portions, polygonal portions, or any other appropriate shapes.
• Thefirst buoy302 of thebuoy system300 may be generally similar in geometry to thebuoy14. It will be understood that thefirst buoy member302 may be formed in the appropriate manner including shape or size to achieve selected results. Nevertheless, thefirst buoy member302 generally includes an exterior diameter that may be slightly smaller than the interior diameter of thetube12. Therefore, thefirst buoy member302 may be able to move within thetube12 during the centrifugal process. Also, as discussed above, thetube12 may flex slightly during the centrifuging process, thus allowing thefirst buoy member302 to include an exterior diameter substantially equivalent to the interior diameter of thetube12. As discussed further herein, during the centrifugation process, a portion of the fraction of a sample may pass between the exterior wall of thefirst buoy member302 and thetube12.
• Thefirst buoy member302 may generally include a density that is substantially equivalent to a first or selected fraction of the sample. If the sample to be separated includes whole blood and is desired to separate the red blood cells from the other portions of the sample, thefirst buoy member302 may have a selected density that may be about 1.00 grams per cc (g/cc) to about 1.10 g/cc. It will be understood that the density of thefirst buoy member302 may be any appropriate density, depending upon the fraction to be separated, and this range of densities is merely exemplary for separating red blood cells from a whole blood sample.
• In addition, thefirst buoy member302 includes a collection face orarea308 at a proximal or upper portion of thefirst buoy member302. Thecollection face308 generally defines a concave area of thefirst buoy member302 and may have a selected angle of concavity. Thebuoy assembly300 defines a central axis D. Thecollection face308 defines a surface E that is formed at an angle γ to the central axis D of thebuoy system300. The angle γ may be any appropriate angle and may be about 0.5° to about 90°. The angle γ may, however, be between about 45° and 89.5°. Nevertheless, it will be understood that the angle γ may be any appropriate angle to assist in collection of a selected fraction or portion of the sample by thefirst buoy member302.
• A bottom orlower surface310 of thefirst buoy member302 may define a bottom face. Thebottom face310 may also be formed at an angle D relative to the central axis D. Thebottom surface310 defines a surface or plane F that may be formed at an angle Δ relative to the central axis D of thebuoy system300. The angle Δ may be any appropriate angle and may be about 90° to about 160°. For example, the angle Δ may be about 15°. Similarly to thebuoy bottom face48, thebottom surface310 defines an apex312 that may first engage the bottom12d of thetube12, such that most or the majority of thebottom surface310 does not engage thetube12. As illustrated further herein, the apex312 allows for a free space or gap to be formed between thebottom face310 of thefirst buoy member302 and the bottom12bof thetube12.
• Thesecond buoy member304 may include an outer diameter substantially equivalent to the outer diameter of thefirst buoy member302. Therefore, thesecond buoy304 may move with thefirst buoy302, particularly if thesecond buoy304 is interconnected with thefirst buoy302 with the buoycentral cylinder306. Nevertheless, thesecond buoy member304 may be allowed to move substantially freely within thetube12 during the centrifuging process.
• Thesecond buoy member304 also includes an upper orsuperior surface314 that defines a plane G that is formed at an angle relative to the central axis D of thebuoy system300. The angle ε of the plane G relative to the central axis D of thebuoy system300 may be any appropriate angle. For example, the angle ε may be about 90° to about 150°. Generally, the angle ε may assist in allowing a selected fraction or a portion of the sample to pass over thetop surface314 and past thesecond buoy member304 during the centrifuging process.
• Thesecond buoy member304 also define a bottom orinferior surface316 that also defines a plane H that may be formed at an angle K relative to the central axis D of thebuoy system300. The angle K may be any appropriate angle, such as about 90° to about 150°. Nevertheless, the angle K may be substantially complimentary to the angle γ of thecollection face308 of thefirst buoy member302. For example, if the angle γ is about 80°, the angle K may be about 100°, such that substantially 180° or a straight line is formed when thefirst buoy member302 engages thesecond buoy member304. This may be for any appropriate reason, such as extraction of a fraction that may be disposed near thecollection face308 of thefirst buoy member302. Nevertheless, the angle K may be any appropriate angle as the angle γ.
• Thesecond buoy member304 may be formed to include any appropriate density. For example, thesecond buoy member304 may include a density that is less than the plasma fraction of a whole blood sample. It will be understood that thesecond buoy member304 may include any appropriate density and a density that is less than the plasma fraction of a whole blood sample is merely exemplary. Nevertheless, if a whole blood sample is desired to be separated and the plasma sample is to be substantially separated from another fraction, thesecond buoy member304 may include a density that is less than the plasma fraction of the whole blood sample. Therefore, the density of thesecond buoy member304 may be about 0.01 g/cc to about 1.03 g/cc. As described herein, if thesecond buoy member304 includes a density less than the plasma fraction of a whole blood sample and thefirst buoy member302 includes a density greater than that of the red blood cells, thebuoy system300 may be substantially positioned near an interface between the red blood cell fraction and the plasma fraction of a whole blood sample. Therefore, as discussed above, and further described herein, the platelet or buffy coat fraction of the whole blood sample may be substantially collected near or in thecollection face308 of thebuoy system300.
• Thebuoy post306 may operably interconnect thefirst buoy member302 and thesecond buoy member304. Thebuoy post306 may be any appropriate connection member. The buoy post need not be a single cylindrical portion. For example thebuoy post306 may include one or more members interconnecting thefirst buoy member302 and thesecond buoy member304, such as around a perimeter thereof. In addition, thebuoy post306 may include any appropriate shape or geometry.
• Thebuoy system post306 may be rigidly affixed to thefirst buoy member302 and thesecond buoy member304, such that thefirst buoy member302 may not move relative to thesecond buoy member304 and vice versa. Alternatively, thebuoy post306 may be slide ably connected to either or both thefirst buoy member302 and thesecond buoy member304. According to various embodiments, thebuoy post306 is generally fixedly connected to thefirst buoy member302 and slide ably interconnected to thesecond buoy member304. Thebuoy post306 may include a catch portion orlip320 that is able to engage a portion of thesecond buoy member304, such that a range of travel of thesecond buoy member304, relative to thefirst buoy member302 is limited. Nevertheless, the range of travel of thesecond buoy member304 toward thefirst buoy member302 may be substantially unlimited until thesecond buoy member304 engages thefirst buoy member302.
• In various embodiments, thebuoy post306 may also define a central cannula or bore322. The post bore322 may include aconnection portion324 substantially defined near an upper or a proximal end of thebuoy post306. This may allow for interconnection of various components with thebuoy post306, such that various components may be moved through thebore322 from an exterior location. Thebuoy post306 may also define a port orcannula326 that connects thepost cannula322 with thecollection face308. Therefore, a substance may travel through thepost cannula322 and through theport326. Various substances may then be provided to or removed from thecollection face308 of thefirst buoy member302.
• In various embodiments, thebuoy system300 may be used to separate a selected multi component sample, such as a whole blood sample. With continuing reference toFIGS. 6A and 6B, and reference toFIGS. 7A-7D, a method of using thebuoy system300, according to various embodiments, is illustrated and described. With reference toFIGS. 7A-7D, like reference numerals are used to indicate like portions of thetube12 and the associated mechanisms described inFIGS. 1-3. Therefore, it will be understood that thebuoy system300 may be used with thetube12 or any other appropriate tube or container system or apparatus. Nevertheless, for simplicity, the description of a method of use of thebuoy system300 will be described in conjunction with thetube12.
• Thetube12 may include thecap18 that further defines a plasma valve orport20. Extending through thecap18 and interconnecting with a first flexible tube ormember92, theplasma port20 may be used to extract a selected fraction of the sample that is positioned above thesecond buoy member304. Thetube12 may also define a second port21, which may also be referred to as a platelet rich plasma (PRP) port. As discussed herein, a second flexible member, such as a flexible tube21a, may interconnect the PRP port21 and aconnection portion324 of abuoy cylinder306. As illustrated above, thefirst tube92 may also be interconnected with a selected portion of the system, such as thetop surface314 of thesecond buoy member304. As illustrated above, a valve may be positioned and is operably interconnect thetube92 with theupper surface314 of thesecond buoy member304. Nevertheless, such a valve is not necessary and it may be provided merely for convenience.
• Other portions of theblood separator system20, particularly those portions of thetube12 and thecap18 that have various valves connected therewith may be included in thetube12 and used with thebuoy system300. Nevertheless, once thebuoy system300 is interconnected, it may be positioned in the interior of thetube12 and thesyringe204 used to place a sample into thetube12. The sample may be expressed from thesyringe204 into the interior of thetube12 and the sample may be any appropriate sample, such as a whole blood sample. Nevertheless, it will be understood, such as discussed above, various other samples may be used, such as bone marrow samples, a mixture of bone marrow and whole blood or non-biological fluids or materials. It will be understood that twobuoys302 and304 may generally be near one another when the sample is positioned in thetube12, but are illustrated apart for clarity of the present discussion.
• Also, the sample may be placed in thetube12 according to various embodiments. As described above, an anticoagulant or other components may be mixed with the whole blood sample, if a whole blood sample is used, before the whole blood sample is positioned within thetube12. As is apparent to one skilled in the art, an anticoagulant or other components may be mixed with a bone marrow aspirate sample or a sample of bone marrow aspirate and whole blood, if such samples are used before such sample is positioned within thetube12. Thesyringe204 is connected with theplunger port22 extending from thecap18, although a plunger may not be used in various embodiments.
• After the sample is positioned within thetube12, as described above, a cap may be positioned over theport22, such that the sample is not allowed to escape from thetube12. After the sample is placed in thetube12 and the cap placed on theport22, thetube12 including the sample and thebuoy system300 may be centrifuged.
• With reference toFIG. 7B, after a centrifugation of thetube12, including thebuoy system300, substantially three fractions of the sample may be formed. Afirst fraction330 may be positioned between thebottom face310 and the bottom of thetube44. Amiddle fraction332 may be positioned between thecollection face308 and thebottom surface316 of thesecond buoy304. In addition, athird fraction334 may be positioned between theupper surface314 and thecap18 of thetube12. Generally, thefirst fraction330, themiddle fraction332, and thethird fraction334 are substantially physically separated with thebuoy system300. During the centrifugation process, thetube12 may flex slightly to allow for ease of movement of thebuoy system300 through thetube12 and the sample. Nevertheless, thebuoy system300, during the centrifugation process, substantially creates the threefractions330,332, and334 without the operation of an operator. Therefore, the formation of at least three fractions may be substantially simultaneous and automatic using thebuoy system300.
• Thebuoy system300 substantially separates thefractions330,332, and334, such that they may be easily removed from thetube12. For example, with reference toFIG. 7C, a syringe orother instrument340 may be used to extract themiddle fraction332 by interconnecting a cannula orbored tube342 with theconnection portion324 of thebuoy cylinder306. By drawing theplunger344 into theextraction syringe340, a vacuum or upward force is produced within theextraction syringe340. This force draws themiddle fraction332 through theports326 of thebuoy post306 and through thebuoy cannula322. Therefore, themiddle fraction332 may be extracted from thetube12 without substantially commingling themiddle fraction332 with either thefirst fraction330 or thethird fraction334. Themiddle fraction332 is drawn in the direction of arrow M through thecannula322 and into theextraction syringe340.
• It will be understood that the second tube21amay also be used. Theextraction syringe340 may be interconnected with the PRP port21 that is interconnected with theconnection portion324 of thebuoy cylinder306. As discussed herein, the buoy cylinder allows access to the middle fraction332 (platelet rich portion) between the buoy portions. Thus, it will be understood, that access may be obtained and the middle fraction332 (platelet rich portion or buffy coat of the sample), between the two buoys, may be extracted in a plurality of ways. The illustrations and method described herein is merely exemplary. For example, if bone marrow aspirate is used as the sample, the PRP port21 would allow for extraction of undifferentiated nucleated cells. In various embodiments, the PRP port21 allows for extraction of the buffy coat.
• Alternatively, if thepost306 is not provided other portions may be provided to gain access to themiddle fraction332. For example, if a plurality of members are provided around the perimeter of thefirst buoy302 and the second buoy304 a valve portion, such as a puncture-able valve, may be provided in thesecond buoy304 to be punctured with an object. In this way an extraction needle may puncture the valve to gain access to themiddle fraction332. Regardless, it will be understood that thebuoy system300 may be able to form a plurality of fractions, such as the threefractions330,332, and334 and at least themiddle fraction332 may be extracted without substantially commingling the various fractions.
• During the extraction of themiddle fraction332 through thecannula322, thesecond buoy member304 may move in the direction of arrow M toward thefirst buoy member302. As described above, thecollection face308 of the first buoy member may include an angle γ that is substantially complementary to thebottom face316 of thesecond buoy member304. Therefore, if thesecond buoy member304 is allowed to move along thebuoy cylinder306, thebottom face316 of thesecond buoy member304 may be able to substantially mate with thecollection face308 of thefirst buoy member302. Alternatively, if thesecond buoy member304 is not allowed to move, the second buoy member may be provided with a vent port or valve, such that the extraction of themiddle fraction332 from thecollection face308 may not be hindered by the buildup of undesirable forces. Nevertheless, if thesecond buoy member304 may move, the interaction of thebottom face316 of thesecond buoy member304 may assist in substantially removing the entiremiddle fraction332 from thetube12. As described above, thebottom face60 of theplunger16 may also serve a similar purpose when engaging thecollection face46 of thebuoy14.
• With reference toFIG. 7D, once themiddle fraction332 has been extracted from thetube12, thesecond buoy member304 may substantially mate with a portion of thefirst buoy member302. As discussed above, thesecond buoy member304 may substantially only mate with thefirst buoy member302 if thesecond buoy member304 is able to substantially move relative to thefirst buoy member302. Therefore, it will be understood that thesecond buoy member304 need not necessarily mate with thefirst buoy member302 and is merely exemplary of an operation of various embodiments. Nevertheless, once themiddle fraction332 has been extracted from thetube12, theport20 may be used in conjunction with a selected instrument, such as aplasma extraction syringe212 to remove the plasma or thethird fraction334 from thetube12 using theextraction tube92 interconnected with theport20.
• As described above, thetube92 allows for extraction of thethird fraction334 from thetube12 without commingling thethird fraction334 with the remainingfirst fraction330 in thetube12. Therefore, similar to the separator andextraction system10, three fractions may be substantially formed within thetube12 with thebuoy system300 and may be extracted without substantially commingling the various fractions. Once thethird fraction334 is extracted from thetube12, thebuoy system300 may be removed from thetube12, such that thefirst fraction330 may be removed from thetube12. Alternatively, thefirst fraction330 may be discarded with thetube12 and thebuoy system300 as a disposable system. Alternatively, the system may be substantially reusable, such that it can be sterilized and may be sterilized for various uses.
• The description of the method of use of thebuoy system300 is exemplary of a method of using a system according to various other embodiments. It will be understood, however, that various specifics may be used from various embodiments to allow for the extraction of selected fractions. For example, the centrifugation process may be substantially a single step centrifugation process. Thebuoy system300, according to various embodiments, may allow for the formation of three fractions during a single centrifugation process. This centrifugation process may occur at any appropriate speed, such as about 1000 RPM to about 8000 RPM. This speed may produce a selected gravity that may be approximately 4500 times greater than the normal force of gravity. Nevertheless, these specifics are not necessary to the operation of thebuoy system300 according to various embodiments. Thebuoy system300, according to various embodiments, may be used to extract a plurality of fractions of a sample after only a single centrifuging process and without substantially commingling the various fractions of the sample.
• With reference toFIG. 8, the blood collection and separation system that includes thetube12, according to various embodiments, may be filled with a multi-component fluid or solution, such as blood from a patient, is illustrated. Thetube12 may include any appropriate separation system, such as theseparation system300. Nevertheless, in addition to filling thetube12 with a fluid from thesyringe204 any appropriate method may be used to fill thetube12. For example, when a solution, including a plurality of components, is placed into thetube12 it may be collected directly from a source.
• For example, apatient350 may be provided. Thepatient350 may be provided for a selected procedure, such as generally an operative procedure or other procedure that requires anintravenous connection352, such as a butterfly needle, to be provided in thepatient350. Theintravenous connection352 generally provides atube354 extending therefrom. Thetube354 may be used to withdraw fluids from thepatient350 or provide materials to thepatient350, such as medicines or other selected components. Nevertheless, theintravenous connection352 is generally provided for various procedures and may be used to fill thetube12.
• Thetube354 may interconnect with theplunger port22 or any appropriate portion of thetube12. Theport22 may be used to connect with thetube354 in a similar manner as it would connect with thesyringe204, if thesyringe204 was provided. Nevertheless, it will be understood that thetube354 may be provided directly to thetube12 from thepatient350. This may reduce the number of steps required to fill thetube12 and reduce possible cross-contamination from thepatient350 with the various components. Moreover, making a connection directly with thepatient350 may make the withdrawal and collection of blood from thepatient350 more efficient.
• Once thetube354 is interconnected with thetube12 the pressure differential between the patient350, such as the intravenous pressure of the blood, may be used to fill thetube12 to a selected volume. In addition, avacuum system356 may be provided Thevacuum system356 may include a vacuum inducing portion ormember358, such as a resilient bulb. Thevacuum inducing member358 may be interconnected with thetube12 through a selected connectingportion360.
• Thevacuum connecting portion360 may interconnect with anorifice362. Theorifice362 may be interconnected or extend from thecap18 or provided in any appropriate portion with thetube12. Nevertheless, a first one-way valve364 may be provided along theconnection portion360 or near theorifice362. The first one-way valve364 provides that a flow of a fluid, such as a gas, may pass in a first direction but not in a second. A second one-way valve366 may also be provided downstream from the first one-way valve364. In this way, a vacuum may be created with thevacuum inducing member358, such that air is drawn out of thetube12 and removed through the second one-way valve366 in the direction of arrow V. Due to the first and second one-way valves364,366 the air is generally withdrawn from thetube12 without substantially allowing the air to flow back into thetube12. Thus, a vacuum can be created within thetube12 to assist with removing a selected volume of fluid, such as blood, from thepatient350.
• Because thetube12 may be filled substantially directly from thepatient350, the collection of the fluid, such as blood, may be provided substantially efficiently to thetube12. Although any appropriate mechanism may be used to assist in withdrawing the blood from thepatient350 thevacuum system356 may be provided including thevacuum inducing member358. Any appropriate vacuum creating device may be used, such as a mechanical pump or the like. Nevertheless, thetube12 may be filled for use during a selected procedure.
• As discussed above, thetube12 may be used to separate a selected portion of the blood obtained from thepatient350 substantially intraoperatively. Therefore, the collection or separation of the various components may be substantially autologous and substantially intraoperatively. Moreover, obtaining the fluid directly from thepatient350 may increase the efficiency of the procedure and the efficiency of the intraoperative or the operative procedure.
• With reference toFIG. 9, theseparator10 may be used to separate any appropriate material. The material may be separated for any purpose, such as a surgical procedure. For example, a selected fraction of a bone marrow aspirate or a bone marrow portion may be produced with theseparator10 according to various embodiments. The selected fraction of the bone marrow aspirate may include various components, such as undifferentiated cells. The various undifferentiated cells may be positioned in a selected scaffold or relative to a selected portion of a patient for providing a volume of the undifferentiated cells to the patient. As known to those skilled in the art, a selected portion of the patient may include bone, cartilage, connective tissue, or any other tissue. Also as known by those skilled in the art, a selected portion of the patient may include a defect in bone, cartilage, connective tissue and/or any other tissue. It will be understood that the method described according toFIG. 9 is merely exemplary of various embodiments that may be used to provide a selected fraction of a bone marrow aspirate or other material to a patient or selected position. The selected portion may be placed on the scaffold in any appropriate manner, such as by spraying, dipping, infiltrating, or any appropriate method.
• A method of selecting or creating a selected fraction of a bone marrow aspirate in a selected scaffold according to amethod400 is illustrated inFIG. 9. Generally, themethod400 may start inblock402 in obtaining a bone marrow aspirate volume. The bone marrow aspirate (BMA) may be obtained in any selected or generally known manner. For example, a selected region of bone, such as a portion near an operative procedure, may be used to obtain the bone marrow aspirate. Generally, an accessing device, such as a syringe and needle, may be used to access an intramedullary area of a selected bone. The BMA may then be withdrawn into the syringe for various procedures. Once a selected volume of the BMA is obtained inblock402, the BMA may be positioned in theseparator10 according to various embodiments inblock404. The BMA may be positioned in any appropriate separator, such as those described above including theseparator10. Once the BMA is positioned in theseparator10, a selected fraction of the BMA may be separated from the BMA inblock406.
• BMA is a complex tissue comprised of cellular components (that contribute to bone growth) including red and white blood cells, their precursors and a connective tissue network termed the stroma. Bone marrow stromal cells or mesenchymal stem cells have the potential to differentiate into a variety of identifiable cell types including osteoblasts, fibroblasts, endothelial cells, reticulocytes, adipocytes, myoblasts and marrow stroma. The selected fraction of the BMA may include undifferentiated cells or any appropriate portion of the BMA. The fractionation or separation of various fractions of the BMA may allow for a volume of BMA to be taken from a single location and the separation or concentration of the selected portion may be performed in theseparator10. Generally, obtaining a small volume of the selected portion from a plurality of locations may be used to obtain an appropriate volume of BMA or selected fraction of the BMA. Nevertheless, theseparator10 may allow for separating a selected volume from a single location from which the BMA is obtained. This may reduce the time of a procedure and increase the efficiency of obtaining the selected fraction of the BMA.
• In addition to obtaining a volume of the BMA inblock402, a volume of whole blood may be obtained inblock408. The volume of blood obtained inblock408, according to any appropriate procedure, including those described above, may then be positioned in theseparator10, inblock410. The whole blood may be positioned in any appropriate separator, such as those described above or a separator to separate a selected fraction of the whole blood. As described above, the whole blood may be separated into an appropriate fraction, such as a fraction including a platelet portion or buffy coat. The whole blood may be separated into selected fractions inblock412. It will be understood that the BMA and the whole blood volume may be obtained substantially simultaneously or consecutively inblock402 and408. In various embodiments, concentrated BMA, such as themiddle fraction332,226 comprising nucleated cells inseparator10 has a concentration of nucleated cells that is at least 4 times the concentrate of nucleated cells in BMA. Similarly, the selected fractions of the BMA obtained inblock406 and whole blood obtained inblock412 may also be performed substantially sequentially or simultaneously. For example, theseparator10 including the volume of the BMA may be positioned in a separating device, such as a centrifuge, substantially opposite, so as to balance, theseparator10 including the volume of the whole blood. Therefore, a single separation, such as centrifuge procedure may be used to separate both the BMA and the whole blood into selected fractions. This again may increase the efficiency of the procedure to provide both a selected fraction of the BMA and a selected fraction of the whole blood substantially simultaneously.
• The selected fractions of the BMA and the whole blood, provided inblock406 and412 may be harvested inblock414. The selected fractions of the BMA and the whole blood, may be harvested inblock414 for appropriate purposes, such as those described herein. Theseparator10 may be used to obtain the selected fractions of the BMA and the whole blood, through various procedures, such as those described above.
• A plurality ofseparators10 may be used to obtain a larger quantity of the selection fractions and such quality of selected fractions may be pooled together. In various embodiments, the BMA aspirate can be concentrated alone or in combination with whole blood. In various embodiments, whole blood may be added to theseparator10, and the resulting buffy coat fraction (middle fraction332,226) may not only contain the at least 4 times greater concentration of nucleated cells from bone marrow, and may include at least 5 times greater concentration of white blood cells from the whole blood and at least 8 times greater concentration in platelets from the whole blood. In addition, circulating stem cells from whole blood may be concentrated with the mature white blood cells in the buffy coat.
• After harvesting the selected fractions of the BMA and the whole blood inblock414, the selected fraction of the BMA may be positioned on an appropriate scaffold inblock416. The scaffold inblock416 may be any appropriate scaffold, such as synthetic bone substitutes or allergenic tissue. Examples of a scaffold include, but are not limited to, bone, cartilage, bone substrates, ceramics, biopolymers, collagens, metal, and the like. The scaffolds may be used for appropriate procedures, such as hard or soft tissue grafting, including uses in non-union or chronic wounds. The undifferentiated cells of the BMA may allow for a substantial source of cells for use during a substantially natural healing after an operative procedure, for example, the natural healing of a patient may use the supplied undifferentiated cells. In such a natural healing of a patient, the undifferentiated cells may be applied to a wound, a defect, a graft site, a bone, cartilage, connective tissue. and the like. Therefore, the scaffold may be positioned in a selected portion of the anatomy and the cells may be allowed to grow and differentiate into selected portions in the implanted position.
• It is well known to those skilled in the art that bone marrow contains hematopoietic and mesenchymal stems cells that are precursors for most of the cells found within the body. In general, the hematopoietic cells, along with angiogeneic growth factors, such as those found in platelets, will promote angiogenesis. Angiogenesis is a necessary stage in wound healing of most tissues and treatment of ischemia. The mesenchymal stem cells are the cells responsible for the formation of bone, tendon, ligament, articular cartilage, muscle, fat, intervertebral discs, meniscus, skin, and any other structural tissue found in the body. In various embodiments, a concentration and delivery of these precursor cells, with or without platelet concentrate, will improve therapeutic uses over the native bone marrow.
• In addition to positioning the selected fractioning of the BMA and the scaffold inblock416, the platelets of the whole blood may be positioned on or near the scaffold ofblock418. The platelets of the whole blood fraction positioned in the scaffold ofblock418 may assist the undifferentiated cells and the anatomy into which the scaffold is positioned to allow for a substantially efficient and complete healing. The platelet rich fraction of the whole blood sample may include various healing and growth factors that may assist in providing an efficient and proper healing in the anatomy. Therefore, the undifferentiated cells of the BMA, or other selected fraction obtained from the separation of the BMA, and the selected fraction of the whole blood, obtained from the separator, may be used with the scaffold to provide a substantially efficient implant.
• In some embodiments,harvest block414 may be combined with a growth factors which may include any of the well-known growth factors such as Platelet-Derived Growth Factor (PDGF), Transforming Growth Factor Beta (TGF-β), Insulin-Like Growth Factor (IGF), Fibroblast Growth Factor (FGF), Epidermal Growth Factor (EGF), Vascular Endothelial Growth Factor (VEGF), Bone Morphogenetic Proteins (BMPs), and vectors for gene therapy. In various embodiments,harvest block414 may be combined with cellular solutions, suspensions, and materials including osteoblasts, osteoprogenitor cells, chondroblasts, stem cells, or fibroblasts may also be used, as may solutions or suspensions containing other therapeutic agents such as antibiotics, analgesics, pharmaceutical agents, antithrombinolytics, or chemotherapeutic agents. In various embodiments, the buffy coat, platelet fraction, and/or undifferentiated cell fraction (themiddle fraction332,226) may be combined with an activator such as thrombin solutions and the like. In various embodiments themiddle fraction332,226 may be used alone for cartilage repair. In various embodiments, the platelet rich fraction may be used to fill a cartilage defect with a fibrin matrix, or it may be mixed with other cell sources such as autologous chondrocytes, synovial cells, bone marrow cells, or to mix with the blood clot formed during microfracture. In addition, theseparator10, or any appropriate separator, such as that described above, may allow for a substantially quick and efficient separation of the BMA and the whole blood into an appropriate fraction for use in the procedure. Other examples include pooling whole blood and/or BMA from different sites of the anatomy or from different sources.
• In various embodiments, the concentrated bone marrow cells can also be included with a carrier to aide in delivery and to help maintain the cells' location after implantation. Examples of carriers can include fibrin, concentrated fibrin, demineralized bone matrix, gelatin, collagen, porous calcium based ceramics, porous metal, synthetic fiber matrices, or resorbable matrices. In addition, carriers can be made from other autogeneic, allogenic, and xenogeneic tissues.
• After the selected portion of the BMA and the whole blood are positioned on the scaffold inblocks416 and418 the scaffold may be implanted inblock420. As described above, the scaffold may be implanted in any appropriate position in theblock420 for various procedures. It will be understood that the scaffold may be implanted for any appropriate procedure and may allow for positioning the selected portion of the BMA, such as undifferentiated cells, and the selected portion of the whole blood, such as platelets, relative to a selected portion of the anatomy. The scaffold may allow for a bone ingrowth, such as allowed with the undifferentiated cells, to assist in healing of a selected portion of the anatomy. In various embodiments, concentrated bone marrow aspirate can be used in articular cartilage repair. Themiddle fraction332,226 can be added to a focal defect or to an osteoarthritic defect. The defects can be in any joint that contains articular cartilage. In various embodiments, themiddle fraction332,226 can promote the formation of repair tissue. In addition, these cells can be added to a microfracture technique in order to increase the mesenchymal cells present in the defect and increase the amount and quality of repair tissue that forms. In various embodiments, themiddle fraction332,226 can be delivered in one of the carriers listed above. In various embodiments, for delivery to cartilage, themiddle fraction332,226 in an autologous fibrin or concentrated fibrin is activated with an activating solution so that it forms a 3-D gel in situ and holds themiddle fraction332,226 within the cartilage defect. In various embodiments, the concentrated bone marrow can also be used in meniscus repair. The concentrated bone marrow can be used to fill a tear with the meniscus, or in can be used to soak a graft used to replace the meniscus after a full or partial meniscectomy. In various embodiments, concentrated bone marrow aspirate used in combination with platelet rich plasma can also be used for repair of meniscus. In various embodiments, concentrated bone marrow aspirate can be used to repair bone. In various embodiments, themiddle fraction332,226 can used alone, or mixed with an appropriate carrier such as demineralized bone matrix, calcium based ceramics, fibrin, or concentrated fibrin. The defects in bone could be found in long bones, cranium, sternum, and spine. One specific placement of concentrated bone marrow aspirate would be to deliver the undifferentiated cells to a freeze dried demineralized bone product (such as the Bonus DBM product from Biomet Biologics) under vacuum. In various embodiments, the concentrated bone marrow can infiltrate the graft, and the plasma in the bone marrow may hydrate the bone matrix and create an injectable carrier. The undifferentiated cells may have differentiating growth factors included within the demineralized bone to stimulate cartilage and bone formation. In various embodiments, the concentrated bone marrow can be delivered to the patient with a growth factor that will induce proliferation, chemotaxis, and/or morphogeneis. Examples of growth factors that could be used include PDGF, TGF-b, IGF, VEGF, EGF, CTGF, FGF, and any of the BMPs.
• The description of the invention is merely exemplary in nature and, thus, variations that do not depart from the gist of the invention are intended to be within the scope of the invention. Such variations are not to be regarded as a departure from the spirit and scope of the invention.

Claims (32)

1. A method for concentrating bone marrow aspirate, the method comprising:

obtaining a volume of bone marrow aspirate from a mammal;

loading the volume of bone marrow aspirate into a separator comprising two buoys, the separator operable to separate the aspirate into three or more fractions;

centrifuging the separator creating at least one fraction comprising a concentrated bone marrow aspirate; and

extracting the at least one fraction comprising a concentrated bone marrow aspirate.

2. The method according toclaim 1 wherein the at least one fraction comprises at least one of the group consisting essentially of hematopoietic stem cells, stromal stem cells, mesenchymal stem cells, endothelial progenitor cells, red blood cells, white blood cells, fibroblasts, reticulacytes, adipose cells, and endothelial cells.

3. The method according toclaim 1 wherein an amount of nucleated cells in the at least one fraction is greater than or equal to 4 times an amount of nucleated cells found in the volume of bone marrow aspirate.

4. The method according toclaim 1 further comprising applying the at least one fraction into a patient.

5. A method for concentrating bone marrow aspirate and peripheral blood, the method comprising:

collecting a volume of bone marrow aspirate and a volume of peripheral

blood from a patient;

loading the volume of bone marrow aspirate and the volume of peripheral blood into a separator comprising two buoys, separator being operable to separate a combination of the volume of aspirate and the volume of blood into three or more fractions;

centrifuging the at least one separator operably creating at least one fraction comprising a concentration of at least one of bone marrow aspirate and peripheral blood; and

withdrawing the at least one fraction comprising the concentration.

6. The method according toclaim 5 wherein the concentration comprises at least one of the group consisting essentially of hematopoietic stem cells, stromal stem cells, mesenchymal stem cells, endothelial progenitor cells, red blood cells, white blood cells, fibroblasts, reticulacytes, adipose cells, and endothelial cells.

7. The method according toclaim 5 wherein an amount of nucleated cells in the concentration is greater than or equal to 4 times an amount of nucleated cells in the combination of the volume of aspirate and the volume of blood.

8. A method for treating a defect in a mammal using a concentrated bone marrow aspirate, the method comprising:

drawing a volume of bone marrow aspirate from the mammal;

loading the volume of bone marrow aspirate into a separator comprising two buoys, the separator being operable to separate the aspirate into three or more fractions;

centrifuging the separator;

separating the volume of bone marrow aspirate into a plurality of fractions including a fraction comprising a concentrated bone marrow aspirate;

extracting the fraction comprising a concentrated bone marrow aspirate; and

applying the fraction comprising a concentrated bone marrow aspirate to site of the defect.

9. The method according toclaim 8 wherein the fraction comprising a concentrated bone marrow aspirate is essentially buffy coat including a plurality of undifferentiated cells.

10. The method according toclaim 8 wherein the fraction comprises at least one of the group consisting of hematopoietic stem cells, stromal stem cells, mesenchymal stem cells, endothelial progenitor cells, red blood cells, white blood cells, fibroblasts, reticulacytes, adipose cells, and endothelial cells.

11. The method according toclaim 8 further comprising combining the fraction with a carrier.

12. The method according toclaim 11 wherein the carrier is selected from the group consisting essentially of collagen, hydrogel, a bioabsorbable polymer, a biopolymer, water, buffered solution, fibrin, concentrated fibrin, demineralized bone matrix, gelatin, porous calcium based ceramics, porous metal, synthetic fiber matrices, resorbable matrices, autogeneic tissue, allogenic tissue, xenogeneic tissue, and combinations thereof.

13. The method according toclaim 8 further comprising combining an activating agent with the fraction.

14. The method according toclaim 8 further comprising combining a pharmaceutical agent with the fraction.

15. A method for treating a defect in an animal, the method comprising:

obtaining a volume of bone marrow aspirate and a volume of whole blood from the animal;

loading the volume of bone marrow aspirate into a first separator comprising two buoys, the separator being operable to separate the aspirate into three or more fractions;

loading the volume of whole blood into a second separator comprising two buoys, the separator being operable to separate the aspirate into three or more fractions;

centrifuging the first separator and the second separators, thereby separating the volume of bone marrow aspirate into a plurality of fractions and separating the volume of whole blood into a plurality of fractions.

collecting a fraction of the bone marrow aspirate;

collecting a fraction of the whole blood; and

applying at least one of the fraction of bone marrow aspirate and the fraction of whole blood to site of the defect.

16. The method according toclaim 15 wherein the at least one of the fraction of bone marrow aspirate and the fraction of whole blood comprises at least one of the group consisting of hematopoietic stem cells, stromal stem cells, mesenchymal stem cells, endothelial progenitor cells, red blood cells, white blood cells, fibroblasts, reticulacytes, adipose cells, and endothelial cells.

17. The method according toclaim 15 further comprising combining the at least one of the fraction of bone marrow aspirate and the fraction of whole blood with a carrier.

18. The method according toclaim 17 wherein the carrier is selected from the group consisting essentially of collagen, hydrogel, a bioabsorbable polymer, a biopolymer, water, buffered solution, fibrin, concentrated fibrin, demineralized bone matrix, gelatin, porous calcium based ceramics, porous metal, synthetic fiber matrices, resorbable matrices, autogeneic tissue, allogenic tissue, xenogeneic tissue, and combinations thereof.

19. The method according toclaim 17 further comprising adding an activating agent to the at least one of the fraction of bone marrow aspirate and the fraction of whole blood

20. The method according toclaim 17 further comprising adding a pharmaceutical agent to the at least one of the fraction of bone marrow aspirate and the fraction of whole blood.

21. A method for treating a defect in a patient, the method comprising:

drawing a volume of bone marrow aspirate and a volume of whole blood from the patient;

adding a first anticoagulant to the volume of bone marrow aspirate;

adding a second anticoagulant to the volume of whole blood;

loading the volume of bone marrow aspirate and the volume of whole blood into a separator comprising two buoys, the separator being operable to separate the volume of bone marrow aspirate and the volume of whole blood into three or more fractions;

centrifuging the separator, separating the volume of bone marrow aspirate and the volume of whole blood into a plurality of fractions.

withdrawing a fraction comprising at least one of the group consisting of hematopoietic stem cells, stromal stem cells, mesenchymal stem cells, endothelial progenitor cells, red blood cells, white blood cells, fibroblasts, reticulacytes, adipose cells, and endothelial cells.; and

applying the fraction to site of the defect.

22. The method according toclaim 21 wherein the fraction is essentially buffy coat including a plurality of undifferentiated cells.

23. The method according toclaim 21 further comprising combining the fraction with a carrier.

24. The method according toclaim 32 wherein the carrier is selected from the group consisting essentially of collagen, hydrogel, a bioabsorbable polymer, a biopolymer, water, buffered solution, fibrin, concentrated fibrin, demineralized bone matrix, gelatin, porous calcium based ceramics, porous metal, synthetic fiber matrices, resorbable matrices, autogeneic tissue, allogenic tissue, xenogeneic tissue, and combinations thereof.

25. The method according toclaim 21 further comprising combining an activating agent with the fraction.

26. The method according toclaim 21 further comprising combining a pharmaceutical agent with the fraction.

27. A method of treating a patient with combination of a concentrated bone marrow aspirate and buffy coat, the method comprising:

obtaining a volume of a whole blood from the patient;

obtaining a volume of a bone marrow aspirate from the patient;

forming a buffy coat fraction of the whole blood;

forming a concentrated bone marrow aspirate fraction of the bone marrow aspirate; and

applying at least one of the buffy coat fraction or the concentrated bone marrow aspirate fraction to the patient.

28. The method according toclaim 27, wherein the forming a first fraction of the first whole material and the forming a second fraction of the second whole material includes:

loading the volume of whole blood and the volume of bone marrow aspirate in a container; and

applying a force to the container to form at least three fractions.

29. The method according toclaim 27, wherein the forming a first fraction of the first whole material and the forming a second fraction of the second whole material includes:

loading the volume of whole blood and the volume of bone marrow aspirate in the container having a separating member, the separating member having a specific gravity substantially dependent upon at least one of the at least three fractions; and

centrifuging the container to move the separating member to a selected position relative to the at least one of the volume of whole blood and the volume of bone marrow aspirate to substantially physically separate the at least three fractions.

30. The method according toclaim 27 wherein the at least one of the first fraction or the second fraction comprises at least one of the group consisting of hematopoietic stem cells, stromal stem cells, mesenchymal stem cells, endothelial progenitor cells, red blood cells, white blood cells, fibroblasts, reticulacytes, adipose cells, and endothelial cells.

31. The method according toclaim 27 further comprising combining the at least one of the first fraction or the second fraction with a carrier.

32. The method according toclaim 31 wherein the carrier is selected from the group consisting essentially of collagen, hydrogel, a bioabsorbable polymer, a biopolymer, water, buffered solution, fibrin, concentrated fibrin, demineralized bone matrix, gelatin, porous calcium based ceramics, porous metal, synthetic fiber matrices, resorbable matrices, autogeneic tissue, allogenic tissue, xenogeneic tissue, and combinations thereof.

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