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The metabolically active exMT formed complexes with platelets (Figures 1 and 2) which remained detectable in the circulation for at least 6 h after TBI (Figure 1C).9 Cardiolipin on exMT and CD36 on platelets mediated the exMT-platelet interaction because: (i) cardiolipin is the dominant anionic phospholipid expressed on exMT9 and (ii) the exMT-platelet interaction was blocked by the phospholipid binding proteins annexin V and lactadherin (Figure 2C) and by an antibody against CD36 (Figure 2D), which is a phospholipid receptor37 that is expressed on platelets3938 and promotes phospholipid-mediated endocytosis.40 Second, exMT induced platelets to secrete their α-granule proteins (Figures 3 and 5) but failed to induce them to aggregate (Figure 4D) or promote platelet thrombus formation on the collagen matrix under arterial shear stress ( Online Supplementary Figure S4A-C)

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