Myths & Facts: Plasma Donation

Plasma donations save countless lives each year. Donated plasma is used to produce a variety of plasma-derived medicines that are often the only therapies for many rare and chronic diseases.¹ Some of the uses of plasma include treatment for trauma, burn victims, cancer patients and those with immune system disorders.²

Plasma is the single largest component (55 percent) of human blood that acts as a transporting medium for cells and a variety of substances vital to the human body.¹ It is composed of approximately 92 percent water, with the remaining eight percent a mix of vital substances such as glucose, hormones, proteins, mineral salts, fats and vitamins. The proteins in plasma include antibodies that alert the immune system to the presence of potentially harmful foreign substances.²

According to Olgam Life, a plasma donation service, there were 737 plasma donation centers in the U.S. in 2018.³ In 2010, approximately 19.8 million plasma donations were made. Nine years later, the annual number of donations was 53.5 million. Unfortunately, however, the number of donations significantly declined in the following two years.⁴ While the blame for this is mostly due to the pandemic, a myriad of misconceptions about donating plasma also contribute to the decline. Therefore, it is crucial that individuals understand the facts about plasma donation to help save the lives of those treated with these critical therapies.

Separating Myth from Fact

Myth: Plasma donation isn’t necessary because people can just donate blood.

Fact: Individuals are allowed to donate blood only every 56 days (or approximately every two months) for a total of six donations per year.⁵ However, because plasma is 92 percent water and regenerates much faster than blood, individuals can donate plasma up to two times per week. In fact, countries that collect source plasma rather than extracting it from blood (known as recovered plasma) are about 800 percent more efficient.⁶

The critical starting material for medicine used to treat patients with immune disorders, critical care in hospitals, hemophiliacs, etc., is plasma. It cannot be synthetically produced and is dependent on the generosity of donors who take the time to donate.

Myth: Only certain individuals can donate plasma.

Fact: It’s true that not everyone is eligible to donate plasma, but most are. According to Olgam Life, eligibility criteria ensure both the safety of the donor and the quality of the collected plasma. Generally, donors must be at least 18 years old and weigh at least 110 pounds (50 kilograms). They must be in good health and pass a medical examination. Additionally, potential donors must complete a health history questionnaire to rule out risky behaviors and exposure to certain diseases. However, it’s important to note that these criteria may vary slightly among different plasma donation centers.²

In addition, individuals can donate plasma regardless of their blood type. The plasma used in therapeutic treatments is known as AB plasma, which is universal, meaning it can be given to anyone. As such, the plasma of people with an AB blood type is especially helpful. But, again, it doesn’t matter what the blood type is; plasma from any blood type can be used in therapeutic treatments.²

Myth: Donating plasma is painful.

Fact: Many people believe donating plasma is painful, but that’s not necessarily true. Donating plasma is similar to donating blood. During the donation process, a small needle is inserted into a vein in the arm, which can result in a little discomfort.⁷ After the needle is inserted, staff at the donation center do all they can to make donors comfortable throughout the process. The one difference between plasma and blood donation is that individuals are also required prior to plasma donation to submit to a finger stick test each time so the collection center medical staff can evaluate their protein and hemoglobin levels.⁸

Myth: Plasma donation is time-consuming.

Fact: Yes, the plasma donation process is more time-consuming due to the health screening process and the process of separating the plasma from the blood, but it still only takes a little longer than donating blood. The first plasma donation appointment typically takes approximately two hours, while subsequent appointments take about 90 minutes.⁸

Parsing Out Plasma Therapies

Source: Plasma Protein Therapeutics Association. Plasma. Accessed at www.pptaglobal.org/plasma#plasma-therapies.

Myth: Donating plasma increases one’s risk of getting sick.

Fact: While some people think donating plasma can make them sick, it is completely safe and is monitored by trained professionals throughout the donation process. In fact, strict safety protocols regulated by the U.S. Food and Drug Administration ensure both the safety of donors and the quality of plasma products.

Plasma is a type of apheresis donation, which means the donor gives blood with the help of a machine that draws out whole blood, centrifuges (i.e., spins to separate) it, retains the plasma and then returns the other blood products back to the donor, all through the same needle. This allows the collection of a greater quantity of plasma without risking the health of the donor. A single donor can safely donate up to four units (pints) of plasma every four weeks due to its abundance in the body and ability to quickly replenish.⁹

Plasma donation in collection centers is performed in a highly controlled, sterile environment by professionally trained medical staff. All plasma collection equipment is sterilized, and any equipment that comes into contact with the donor is used only once to eliminate the possibility of transmitting viral infections.⁸ In addition, all supplies used in the donation process are single use.⁶

All new plasma donors go through medical screening during which their vital signs, hematocrit and total protein levels are checked, a physical exam is performed, and medications and health conditions are reviewed. Only when they are determined to be healthy to donate are they allowed to. Indeed, many potential donors do not pass this rigorous health screening. If they are allowed to donate, each time they return, they go through another medical screening and are allowed to donate only if their vital signs, hematocrit or total protein levels are in range. Protein levels are also checked periodically, and if they are not within range, the donors are temporarily deferred until the protein levels return to normal.⁶

There is of course, as with any other procedures, a small risk of side effects. Bruising and nerve irritation are among the most common side effects, typically around the injection site, which can be treated with cold packs. Nerve irritation causes immediate, intense pain at the injection site and can cause shooting pain down the arm and into the hand. If this happens, a technician will immediately remove the needle.

More serious risks of donating plasma may be a drop in blood pressure, which can result in lightheadedness or fainting. Other possible side effects include sweating and paleness, weakness, sudden warmness and nausea or vomiting. Dizziness and blurred or tunnel vision may also occur. A citrate reaction could occur if individuals are sensitive to the chemical citrate, which is added to the separated blood to prevent clotting. If a severe citrate reaction occurs, the donation process is halted. When the remnants of the donation are returned, individuals may experience tingling around their mouth, face, hands or feet. More severe reactions include cramping of the hands or feet, sudden weakness, muscle spasms, chills and shaking, nausea or vomiting, and numbness around the mouth.¹⁰

Myth: Plasma donations are used only for research.

Fact: While research is critical for the advancement of science and medicine, only a very small number of plasma donations are used for research. Rather, the majority of plasma donations are used to produce important medicines that treat patients with rare and chronic conditions but also to treat victims of severe shock, trauma and burns. They are also used to provide temporary immunity in life-threatening situations such as potential exposure to rabies, tetanus and hepatitis A or B.¹¹

When plasma donations are used in research, frequently it is to characterize plasma-treated cells in specific applications, for example in cytokine release and cell count viability. Currently, researchers in search of treatments and cures for serious diseases such as autoimmune disorders and hemophilia use antibodies and proteins found in human plasma to support their work. In addition, different types of proteins (including antibodies) and small molecules are found in human plasma that have the potential to be made into new and existing therapeutics.⁹

Myth: The history of plasma donation is controversial so people should question it.

Fact: Donating plasma has raised some ethical questions for some time. The reason? Plasma donors are paid. The global demand for plasma continues to rise by six to eight percent each year, and the United States supplies two-thirds of the world’s blood plasma, the majority of which is used to develop lifesaving drugs and to treat life-threatening conditions. There is no synthetic substitute for plasma, so drug manufacturers rely on a steady stream of human donors to make up their supply. Treating just one patient with plasma therapies for a year takes between 130 and 1,300 donations. Unfortunately, global demand for plasma far outpaces supply. “The bottom line is if the U.S. didn’t compensate donors, there would not be enough plasma and lives would be lost globally,” the president of the Immune Deficiency Foundation wrote in a February 2019 statement.¹²

Myth: Plasma donor centers target the disadvantaged.

Fact: The fact that plasma donors are paid has led many to believe that donor centers target low-income individuals. It’s true that many individuals donate plasma to supplement their income. A study from the Center for Health Care Research and Policy found that 57 percent of donors at one Cleveland center reported at least a third of their income that month would come from donating plasma. But, others donate to help save lives.¹²

Still, the donor suitability and screening process is the same for all donors whether they are low-income or high-income.⁶ In addition, payment for donations does not change depending on a person’s income. In fact, donation centers don’t inquire about individuals’ income.² The only factor donation centers consider is the donors’ health.

Myth: Many plasma donors donate to support unhealthy lifestyles, so the quality of plasma could be tainted.

Fact: While it’s true that compensation is beneficial, especially for those who need it, individuals are intensely screened to ensure that any effects of unhealthy lifestyles don’t affect the quality of the plasma. Again, strict health screenings are conducted at the beginning of each donation to help ensure the donor is healthy. Every single donation is also tested for transmissible diseases such as HIV, hepatitis A, B, C and syphilis.⁶ Throughout the entire process, a donor interacts with a minimum of four staff members who are trained to identify signs and symptoms that suggest an unhealthy lifestyle. If a donor does not pass the strict health screening criteria, he or she cannot donate plasma.¹¹ Those donors are then entered into a national database that plasma centers must check prior to registering a new donor.⁶ And, if an approved donor’s medical tests come back positive for certain viruses/diseases, his or her plasma is immediately destroyed.¹³

In addition to screening, plasmapheresis and fractionation are intensive processes that create clean, safe plasma for those in need. As mentioned earlier, plasmapheresis is a sanitary, self-contained, automated process during which plasma is separated from red blood cells and other cellular components of blood that are then returned to the donor. According to the Plasma Protein Therapeutics Association, the manufacturing process is known as fractionation. During fractionation, “proteins are separated to create a number of plasma protein therapies using well-established purification methods such as precipitation, centrifugation, separation and filtration. Fractionation employs time, temperature, pH and alcohol concentrations to extract specific therapeutic proteins. These are then subjected to various purification methods and viral inactivation and removal processes to further ensure their safety and efficacy. Preparing a therapy often takes between seven and 12 months between donation and final product release. This sets the production of plasma protein therapies apart from chemical pharmaceuticals and other biologics whose manufacturing processes are much more condensed and whose direct manufacturing costs are a significantly smaller portion of the overall cost. In addition, fractionators invest substantially in research and technologies to increase the quality of proteins extracted from plasma, known as the “yield,” and create new and more effective therapies.”¹⁴

Dispelling the Myths Now

Donating plasma is a selfless act. It saves lives, and it is the only way to provide those who require plasma protein therapies with the treatments they need to survive. What’s more, donating plasma is safe, and adverse events are infrequent.

The future of treatments with plasma-derived therapies depends on the supply of plasma. Unfortunately, misconceptions about plasma donations can prevent people from donating, ultimately contributing to plasma shortages. Healthcare providers can help to prevent shortages by encouraging their patients to donate plasma, as well as by setting the example by donating plasma themselves.