Platelets and spleen

[Bill200]

After a transplant, how long should it be before platelet count and spleen size return to normal?

[Thomas D Schiano, MD]

the spleen is fibrotic from being enlarged for so long--its not destroying the platelets,  there should be no long term sequelae from this unless the platelets were to be extremely low.  probably 20-30 % of pts don't have platelets that return to normal post-transplantation

[Bill200]

"it varies from patient to patient.  in the setting of longstanding splenomegaly the spleen may never regress totally in size post-transplantation and the platelet count may never competely return to normal. "

What does this mean in practical terms?  Is there any negative effect from this condition?  What is happening physiologically?  Is the spleen still "chewing up" the platelets?  Why wouldn't the spleen return to normal size once the cause of the enlargement is eliminated?  Lastly, what percentage (ballpark) of patients' spleen and platelets don't return to normal?  Don't most patients' counts return to normal in a year or so post-transplant?

[Thomas D Schiano, MD]

none of the symptoms that you describe are due to the donation

[thinblood]

Hi Doctor,

Thanks for the reply.

I am a fast bike rider, since after I have donated I am not able to ride for longer periods I am facing numbness sensation on my palms and below the butt, is this because of donating platelets, also I am facing excessive hair loss.

As suggested I will avoid ASA and NSAIDs for the rest of my life.

[Thomas D Schiano, MD]

there should be no long term issues in the donation.  unless the platelet count is extremely low (more or less than 30,000) you should be at no increased risk for bleeding, etc.  avoid medications such as ASA and NSAIDs if possible that affect qualitative platelet function.

[thinblood]

I have donated blood platelets. Will there be any side effects for me. Do I need to take any precautionary steps for rest of my life.

[Thomas D Schiano, MD]

it varies from patient to patient.  in the setting of longstanding splenomegaly the spleen may never regress totally in size post-transplantation and the platelet count may never competely return to normal.