<i>Morphology and Enumeration of Human Blood Platelets</i>

One of two patients in whom early homograft rejection developed after renal transplantation had many antidonor antibodies before operation. By the measurement of gradients across intracorporeal and extracorporeal homografts in this patient, the new kidneys were shown to sequester host immunoglobulins, platelets, white cells and clotting factors. Moreover, the renal venous blood then contained fibrinolytic activity. This presensitized recipient, as well as a second patient who did not have detectable preformed humoral antibodies, gave evidence from clinical observation and from the various clotting tests of disseminated intravascular coagulation with fibrinolysis and a severe bleeding, diathesis. Immunofluorescent and histologic studies revealed a laying down of fibrin in the homograft vessels that continued in some cases to cortical necrosis of the transplanted kidneys or, alternatively, receded at the time fibrinolysis occurred. The variety of rejection seen in these patients has been characterized as an immunologically induced coagulopathy.When a kidney homograft is revasculurized in a recipient who is presensitized to donor antigens there is a substantial risk of either accelerated or hyperacute rejection of the transplant. [1][2][3][4][5] The mechanism of the immediate destruction has been disputed. Two years ago in this journal, a clinical report from our institutions 5 suggested that an instantaneous antigen-antibody reaction or other mechanisms could precipitate a coagulopathy like that of the Shwartzman reaction and that the consequent fibrin thrombi could occlude the renal micro-vasculature and be responsible for cortical necrosis. The principal evidence in support of this contention was from special histologic examinations. Unfortunately, clotting assays were not obtained in these patients.A subsequent publication by Colman and Merrill and their associates confirmed that there were massive fibrin deposits in two human kidneys that had been hyperacutely rejected by apparently presensitized recipients. 6 However, no systemic clotting changes could be detected in either of their patients, nor was there an arteriovenous gradient of any of the measured coagulation factors across the kidney in the most completely studied of these cases. Because of the negative findings, there was no satisfactory explanation even for the local in intravascular coagulation that the authors postulated and no evidence whatever that there had been a systemic clotting disorder at any time. In contrast, studies from our laboratories have shown that noteworthy alterations in local or systemic coagulation regularly occur in presensitized dogs after the transplantation of the kidney, liver or spleen. 7 The same thing has been seen in two recently treated patients whose renal homografts failed promptly. In both these human recipients, studies obtained revealed consumption of clotting factors either within the kidney or systemically, as well as fibrinolysis and a bleeding diathesis. MethodsThe technics of renal transplantation a...

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“…Hematocrit, white-cell counts and platelet counts 18 were assayed in blood anticoagulated with ethylene diamine tetra-acetic acid (EDTA).…”

Section: Hematologic and Coagulation Studiesmentioning

confidence: 99%

Clotting Changes, Including Disseminated Intravascular Coagulation, during Rapid Renal-Homograft Rejection

Starzl¹,

Boehmig²,

Amemiya³

et al. 1970

N Engl J Med

116

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“…Standard methods were used to obtain platelet-rich plasma and platelet-poor plasma. The platelet count (8) (9). In brief, atherosclerosis of the aorta and its main branches was graded subjectively in five individual sectors on a scale of 0 (no lesions)…”

Section: Methodsmentioning

confidence: 99%

Aspirin inhibits development of coronary atherosclerosis in cynomolgus monkeys (Macaca fascicularis) fed an atherogenic diet.

Pick¹,

Chediak²,

Glick³

1979

J. Clin. Invest.

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“…9 Blood samples were collected by aseptic venipuncture with disposable plastic syringes, mixed with EDTA, and then sucked up to 0.5 mark in the WBC pipette. Tip of the pipette was then gently wiped with dry cotton.…”

Section: Exclusion Criteriamentioning

confidence: 99%

Thrombocytopenia during pregnancy: an institutional based prospective study of one year

Pandey¹,

Singh²

2017

Int J Res Med Sci

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Background: Platelets are non-nucleated cellular fragments of megakaryocytes, they play a critical role in haemostasis. Thrombocytopenia, defined as blood platelet count below 150.000/μL is the second leading cause of blood disorders in pregnancy after anemia. It complicates 7 to 10% of all pregnancies. Gestational thrombocytopenia explains 70-80% of all cases of thrombocytopenia in pregnancy. Hypertensive disorders account for approximately 20% and immune thrombocytopenic purpura for about 3-4%. Other etiologies are considered rare in pregnancy.Methods: The study was conducted in the tertiary institute over a period of one year, from January 2016 to December 2016. The samples of blood were collected from the Antenatal out-patient department and from indoor patients of the department of gynecology and obstetrics of the J.K. Hospital, Bhopal, Madhya Pradesh India.Results: Maximum number of patients had moderate degree of anemia around 58%. Most of the cases presented during 30-34 weeks of gestation. The most common etiology was gestational thrombocytopenia.Conclusions: Thrombocytopenia in pregnancy may occur secondary to a variety of causes. Most of these cases occur during specific periods of gestation. Management of pregnant women with platelet disorders requires a multidisciplinary approach and close collaboration between obstetric and hepatologist.

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Morphology and Enumeration of Human Blood Platelets

Cited by 1,213 publications

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Clotting Changes, Including Disseminated Intravascular Coagulation, during Rapid Renal-Homograft Rejection

Clotting Changes, Including Disseminated Intravascular Coagulation, during Rapid Renal-Homograft Rejection

Aspirin inhibits development of coronary atherosclerosis in cynomolgus monkeys (Macaca fascicularis) fed an atherogenic diet.

Thrombocytopenia during pregnancy: an institutional based prospective study of one year

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