Model for mechanisms of liver injury in SCD as it relates to P-selectin deficiency. The top panel shows the role of P-selectin in mediating multicellular adhesive interactions leading to liver injury by vaso-occlusion. The bottom panel shows that the absence of P-selectin results in amelioration of these adhesive effects and lack of leukocyte recruitment to the endothelium, which lead to liver injury by senescence. Hemolysis is not improved by P-selectin deficiency. ESL, E-selectin ligand; PSGL-1, P-selectin glycoprotein ligand-1; RBC, red blood cell. Professional illustration by Patrick Lane, ScEYEnce Studios.