Proposed evolution of PSLP generation during storage of apheresis PLTs at RT. PSL leads to PLT activation with consequent release of PEVs (A) and induction of apoptosis (B), autophagy (C), and necrosis (D). Secondary necrosis may occur (E); autophagy may lead to apoptosis (F). These processes lead to accumulation of necrotic and apoptotic PLTs (DPLTs) during storage of apheresis PLTs at RT. The release of free mitochondria occurs through (A) PLT activation, (F) from unconventional exocytosis of autophagic vacuoles and (G) from necrotic PLTs, which releases organelles due to membrane fragmentation. Apoptotic and necrotic PLTs as well as PEVs, which include free mitochondria (MITO) and other organelles, became PEV ghosts because of storage-induced membranes fragmentation and leakage of internal contents.