Assessment of thrombocytopenic patients for splenectomy.

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Abstract
Platelet survival and splenic sequestration patterns were studied in 32 patients with thrombocytopenia using donor platelets labeled with Chr. A shorter mean platelet lifespan was observed in immune thrombocytopenia (ITP) (mean 12 h) than in hypersplenism (mean 56 h) or marrow hypoplasia (mean 102 h). There was no such correlation between diagnosis and splenic sequestration. A biphasic survival curve was seen in 9 of 22 patients with ITP. Thirteen patients underwent splenectomy with complete (9) or partial (4) response, but no consistent pattern of results was manifest. In vivo isotope studies are of little value in predicting the benefit of splenectomy in thrombocytopenic patients, although they may demonstrate the mechanism of the thrombocytopenia, particularly the biphasic survival curve revealing separate immune and hypersplenic components of platelet destruction in ITP.