What is a significant exception for platelet transfusion during splenectomy?

In the context of splenectomy, platelet transfusions are typically not routine unless there is an impending surgical procedure where bleeding may be a concern or there is significant thrombocytopenia that could compromise hemostasis. The presence of preoperative bleeding serves as a significant exception because it indicates an immediate need to stabilize the patient's hemostatic status.

When a patient shows signs of bleeding, transfusing platelets can help to restore clotting ability and potentially prevent further bleeding during the surgical intervention. This situation underscores the importance of maintaining hemostasis prior to surgery. In contrast, other factors such as a patient's age, underlying malignancies, or previous splenic surgeries do not have the same direct, acute implications for platelet transfusion decisions in the preoperative setting. Each of these factors may influence overall surgical risk or outcomes but does not necessitate an immediate platelet transfusion like the presence of active bleeding would.