Identification of platelet sequestration

When 51Cr-labelled platelets are administered, combined measurements of radioactivity in the liver and spleen and in the blood show that normally about one-third of the platelets are promptly extracted from circulation by the spleen and are released later, with a subsequent monoexponential equilibration with the circulating platelets. A small fraction of the labelled platelets is taken up rapidly and irreversibly by the liver; this is assumed to be due to their being damaged by the labelling process. Splenomegaly is associated with a marked increase in splenic pooling; in contrast, in asplenia, nearly 100% of the labelled platelets are recovered in circulating blood. Surface counting and quantitative scanning have been used to identify the role of the spleen in thrombocytopenia. The clinical usefulness of such data in predicting the results of splenectomy in such patients is, however, debatable, as there is both sequestration and destruction of platelets in the spleen; sequestration is, as a rule, a temporary phase, which does not necessarily mean subsequent destruction, as with red cells.

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