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The average life span of circulating platelets is 8 to 9 days. [17] Life span of individual platelets is controlled by the internal apoptotic regulating pathway, which has a Bcl-x L timer. [18] Old platelets are destroyed by phagocytosis in the spleen and liver.
A platelet transfusion is required immediately if there is severe or life-threatening bleeding. [19] [20] If life-threatening bleeding occurs, for example an intracranial hemorrhage, then the platelet count needs to be increased to decrease the risk of further bleeding (> 100,000 μL −1). [19] [20]
A normal human platelet count ranges from 150,000 to 450,000 platelets/microliter (μL) of blood. [4] Values outside this range do not necessarily indicate disease. One common definition of thrombocytopenia requiring emergency treatment is a platelet count below 50,000/μL. [ 5 ]
The increased possibility of bleeding when the platelet count is over 1 million is due to von Willebrand factor (vWF) sequestration by the increased mass of platelets, leaving insufficient vWF for platelet adhesion. [8] A mutation in the JAK2 kinase (V617F) is present in 40–50% of cases and is diagnostic if present.
Platelets have a life span of 5 to 9 days. Because of this, the U.S. Food and Drug Administration (FDA) expires transfuse-able platelets 5 days post-collection. Typically, hPL is produced from expired platelets that have been stored in frozen conditions no later than 7 days post-collection.
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Thrombotic thrombocytopenic purpura (TTP) is a blood disorder that results in blood clots forming in small blood vessels throughout the body. [2] This results in a low platelet count, low red blood cells due to their breakdown, and often kidney, heart, and brain dysfunction. [1]
In general, patients with acute ITP will only rarely have life-threatening bleeding. [54] Most patients ultimately have lower, but stable platelet counts, which are still hemostatic for the patient. Unlike children and adolescents, ITP is often chronic in adults, even after a splenectomy. [40]
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