Kinetics and mobilization from the spleen of indium-111-labeled platelets during platelet apheresis

The rate and extent of platelet mobilization from the spleen were measured, and their relationship to the removal of platelets from the peripheral blood during discontinuous flow platelet apheresis was determined in four normal volunteers. Autologous platelets were labeled with Indium-111-oxine and in vivo whole body and organ In-111 radioactivity quantitated with a scintillation camera and a computer-assisted imaging system. Dynamic changes in splenic radioactivity were monitored during 12 cycles of platelet apheresis. The number of platelets harvested and changes in whole body and blood In-111 activity were determined during the procedure. The platelet life-span was estimated, and the sites of sequestration of labeled platelets was measured. Platelet apheresis removed a mean of 64 percent of platelets in the circulation; i.e., 48 percent of all platelets in the body. During the procedures, 28.0 +/- 9.4 percent In-111-labeled platelets in the body were removed, splenic radioactivity decreased by 36.5 +/- 13.2 percent, and whole body activity decreased by 34.5 +/- 9.7 percent. In-111 activity in the spleen and whole body decreased in parallel, indicating a dynamic equilibrium between these pools. The life-span of the labeled platelets was 226 +/- 25 hours, similar to that of normal subjects. The major sites of sequestration of senescent platelets were the spleen (37.9 +/- 20%) and liver (30.3 +/- 5.6%); this is similar to that found in normal subjects. We conclude that as platelets are removed from the peripheral blood, the blood pool is rapidly and effectively replenished from the splenic platelet pool. These two pools are in dynamic equilibrium and permit removal of large numbers of platelets without resultant thrombocytopenia. Platelet apheresis does not adversely effect platelet life-span, and the sequestration pattern in the reticuloendothelial system is normal.