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Plasma Donation- process, criteria, side effects- ALL EXPLAINED!!!

In recent times, Plasma Donation has become an important topic of discussion due to its probable effect in treatment of covid-19.

So lets discuss the process of plasma donation in detail.


What is plasma?

Your blood is collection of various materials. 

It mainly consists of-

  • red blood cells
  • white blood cells
  • platelets
  • plasma
    • water
    • proteins such as albumins and globulins
    • coagulation and anti coagulation factors
    • anti bodies such as immunoglobulins (IgG and IgM)
    • nutrients
    • minerals


What is your plasma used for?

  • People with bleeding disorders are unable to clot blood properly. As a result a minor injury may result in internal bleeding, organ damage and even death. The coagulants in donor plasma are helpful in such patients
  • There are more than 150 primary immune deficiency disorders (PID). These individuals have improperly functioning immune systems and do not respond to traditional antibiotics. Without IVIG, they are exposed to frequent and often serious infections.
  • Alpha-1 Antitrypsin - It's deficiency may result in serious lung disease in adults and lung and/or liver disease in both children and adults.
  • Albumin- it is used to treat burns, trauma patients and surgical patients.
  • These are used to treat rabies, tetanus, dialysis patients and organ transplant recipients. They are also used to treat pregnant women who have Rh incompatibility, a condition where the mother and fetus have incompatible blood that can lead to serious injury to the unborn child or even death.
  • Earlier anti body donation has also helped in times of outbreaks such as SERS and MERS. Also its effect in COVID-19 is still debatable but it is used in patients along with other treatment measures 

So plasma, due to its wide variety of contents is used in above mentioned and many more diseases as treatment or prophylaxis management.


Plasma Apheresis Machine
DONOR ELIGIBILTY

  • AGE >18 years
  • Weight -minimum 50kgs
  • Blood pressure - within normal range of 100-130 / 70-90 
  • SEX- males or nulliparous females
  • brief physical examination
  • transfusion history of blood products more than 8 weeks ago
  • Pre blood donation blood tests which include-
    • blood group (A/B/AB/O, Rh phenotype)
    • CBC (complete blood count) this includes Hb, Hct, Platelet count, TLC(total leucocyte count). All of the above should be in normal range for you to qualify as an eligible donor.
    • Screening for HIV, HBV (Hepatitis B virus), HCV (Hepatitis C virus), Syphilis, Malaria. Donors who test negetive for these become eligible
    • Total serum protein 


BEFORE donating plasma-

  • Drink plenty of water or juice to be fully hydrated
  • Notify center personnel if you have had recent surgery
  • Notify center personnel if you have obtained a tattoo or piercing within the past 12 months
  • Notify center personnel if you are taking medication or are under a doctor's care for any medical condition
The information obtained from your sample such as your hemoglobin levels, HIV OR HbsAg status will be kept confidencial and will not be revealed to anyone untill there is medico-legal scenario.
They will only be used by medical professionals for cross matching and finding the proper donor compatibility

CONSENT

Written consent stating -

  • your willingness to donate and that you have been explained about the process, use and side effects of the procedure.
  • you allow your organ sample (here blood product) to be tested for above mentioned tests
  • You don't have any undisclosed use of drugs/ medicines or alcohol or tattoo on your body in last 12 months or any other medical history.


TIP FOR DONOR FOR SAFER PROCEDURE

It is advisable to make sure that all the instruments (except the plasma apheresis machine) used by the technician are new and are disposed off after each procedure.


STEPS

  • A wide bore cannula will be inserted in veins of one of your arms. 
  • this will be connected to a machine (for plasma apheresis)
  • blood that will drain from your vein into the cannula will enter into the apheresis machine

  • before entering the apheresis machine a small amount of anti coagulant - CITRATE is mixxed into your blood. This is to ensure that the blood drawn out from your body, does not clot during the process and can be returned back safely withour any clot formation.
  • the apheresis machine centrifuges (spins) your blood thereby separating your plasma from other blood components.
  • the remaining red blood cells, white blood cells and platelets will be returned back into your vein through the same cannula.
  • The extracted plasma is collected in a bag.
  • In each cycle around 150ml of plasma is collected and takes approximately 10-15 minutes.

  • After each cycle, the remaining blood (after extracting the plasma) is returned back into the vein through the same cannula through which it entered.
  • this cycle repeats untill the process is completed.

  • the complete process takes about 3-4 cycles and a total time of aroud 30-45 minutes.
  • a total of 400-450ml of plasma is extracted from your body till the end of this process. Maximum volume that is recommended is 800ml. 


SIDE EFFECTS

The side effects faced by the donor are similar to what are faced during whole blood donation except the citrate reaction

Not all donors face side effects. If you under go the procedure at a reputed centre then chances of side effects decreases significantly. Also these probablity of these side effects decrease significantly if you did not have any side effects in your 1st blood donation.

  • Anaphylactic reactions- These include chills, nausea, vomiting, faiting, dizziness
  • fluid over load
  • Dehydration- plasma contains water in maximum proportion. Hence donating plasma leads to water loss. It is advisable to keep yourself hydrated before donating plasma.
  • Dizziness, Fainting, Light-headedness, Fatigueness- This is due to loss of vitamins and minerals.
  • Bruising and Discomfort at local site- This is due to needle pricking at local site.
  • Air embolism
  • Citrate reaction- Citrate, which is the anti-coagulant added to the blood before blood enters the machine, might enter our blood stream. This binds to calcium molecules for short time and cause a few side effects-
    • Signs of a citrate reaction include:
      • numbness or tingling, especially in the lips, fingers, and toes
      • feeling vibrations throughout the body
      • experiencing a metallic taste
      • chills
      • shivering
      • lightheadedness
      • muscle twitching
      • a rapid or slow pulse
      • shortness of breath

If these symptoms of citrate reaction are left untreated, they may become more severe. Severe symptoms include:
      • spasms
      • vomiting
      • shock
      • irregular pulse
      • cardiac arrest

In order to prevent these citrate reactions, the centre gives the donor calcium tablets to chew during the process. Also, it is advisable to keep yourself hydrated with water and salts after the process.

FREQUENCY

You can donate plasma every 28 days, up to 13 times per year. 


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SOURCE
  1. Indian red cross society
  2. https://www.healthline.com/health/donating-plasma-side-effects
  3. https://www.donatingplasma.org/
  4. Risks and side effects of therapy with plasma and plasma fractions by SheilaMacLennanMBBS and others
  5. Frequency of immediate adverse effects associated with apheresis donation by B. C. McLeod MD and others 
  6. PLASMA DONATION: HOW DOES AN APHERESIS MACHINE WORK? transfusion fact sheet by australian red cross blood service volumae 4, number 11 by Beverleigh Quested.

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