Hemostasis Today
NewsFeed
Headlines Hematology Health Medicine VTE ASH Plasma Donation
November, 2026
November 2026
M T W T F S S
 1
2345678
9101112131415
16171819202122
23242526272829
30  
Sukanto Paul: Why Platelet Transfusion Is Generally Avoided in TTP
Sukanto Paul/LinkedIn
Nov 15, 2026, 16:21

Sukanto Paul: Why Platelet Transfusion Is Generally Avoided in TTP

Sukanto Paul, Technical Supervisor at Narayana Health, shared a post on LinkedIn:

”TTP is not simply a condition of low platelet count; it is a condition of uncontrolled platelet consumption and microvascular thrombosis.

Let’s understand the mechanism from a transfusion-medicine perspective.

  1. Why does TTP cause thrombocytopenia?In TTP, there is a severe deficiency of ADAMTS13, an enzyme responsible for cleaving ultra-large von Willebrand factor (UL-vWF) multimers.
    Normally:
    Endothelial cells release large vWF multimers.
    ADAMTS13 cleaves these multimers into smaller, less adhesive forms.
    This regulates platelet adhesion and aggregation.
    In TTP:
    ADAMTS13 activity is severely reduced, usually below 10 percent.
    Ultra-large vWF multimers accumulate in circulation.
    These multimers bind platelets excessively.
    Platelets aggregate and form microthrombi in small blood vessels.
    Platelets are consumed, resulting in severe thrombocytopenia.
  2. Why is platelet transfusion avoided?
    If we transfuse additional platelets:
    We introduce more circulating platelets.
    These platelets can bind to the accumulated ultra-large vWF multimers.
    This may promote further platelet aggregation.
    Microvascular thrombus formation may worsen.
    This can potentially aggravate organ ischemia, particularly in the brain, heart and kidneys.
    Important: This is the theoretical concern supported by case reports of deterioration and thrombosis following platelet transfusion. However, a direct causal relationship has not been definitively established.
    There is another important reason: transfused platelets are likely to be consumed rapidly in the ongoing microthrombotic process, so the platelet count increment may be short-lived and clinically unhelpful.
  3. When can platelet transfusion be given in TTP?
    Platelet transfusion may be considered when there is:
    Life-threatening or serious active bleeding.
    Intracranial haemorrhage.
    Major gastrointestinal bleeding.
    An invasive procedure with a substantial bleeding risk, after individual assessment.”

Sukanto Paul: Why Platelet Transfusion Is Generally Avoided in TTP

Stay updated with Hemostasis Today.

Health Hematology Hemostasis Hemostasis News Hemostasis Today Medicine Platelet transfusion Sukanto Paul TTP
NewsFeed