Refrigeration and platelet activation increases platelet surface expression of the sialidase Neu1 providing desialylation of the platelet VWF receptors. Cold-stored platelets undergo clustering of these receptors. GPIbα and GPV are cleaved from the surface of refrigerated platelets by metalloproteinase ADAM17. These phenomena result in increased clearance of the platelets because of the recognition of β-N-acetylglucosamine (β-GlcNac) residues on clustered GPIbα by the α_Mβ₂ integrin receptor present on hepatic macrophages and of desialylated GPIbα by the Ashwell-Morell receptor present on hepatocytes (A). Addition of the sialidase inhibitor, DANA, enhances the recovery and circulation of refrigerated platelets, but did not completely prevent galactose exposure (B).