A patient with ITP has a platelet count of 50,000 and is being planned for splenectomy. What is the best time for platelet infusion in this patient?
In the acute cases with severe bleeding which cannot be brought under control by steroid therapy, fresh blood transfusion or transfusion with platelet concentrates before operation is necessary, and is administered only after the splenic aery has been clamped. Platelets administered before this point in the surgery are unlikely to be effective owing to their rapid clearance by the spleen. Ref: Harrison's Internal Medicine, 17th Edition, Page 721; Bailey and Love's Sho Practice of Surgery, 24th Edition, Page 1089 and 25th Edition, Page 1106
2 hours before surgery
At the time of skin incision
After ligating the splenic aery
Immediately after removal of spleen