Plasma donation
Plasma donation is a medical term of art and refers to the donation of blood plasma of different for the recovery, such as coagulation-active plasma preparations.
The yellow, clear - in the case of obesity, sometimes milky yellow-white - plasma is separated from the cellular blood components such as red blood cells , white blood cells and platelets by so-called plasmapheresis , a special form of apheresis . In most cases, the cellular components are returned to the donor's body. This means that it is possible to donate plasma every third day, i.e. much more frequently than donating whole blood.
Donors / donations
Donors must be between 18 and 68 years old and weigh more than 50 kilograms. With a special medical certificate, donations over the age of 68 are also possible.
Before the first donation, all donors undergo a detailed medical examination including anamnesis and laboratory diagnostics. Regular check-ups are mandatory for multiple donors.
Exclusion criteria according to the guidelines include certain existing or past infectious diseases , existing pregnancy or pregnancy that occurred in the last six months , alcoholism , drug addiction , severe chronic diseases such as heart and vascular diseases or malignant tumors.
Some providers pay their donors an expense allowance.
In Austria, 25 instead of 20 € compensation per donation has been customary for a number of years. Thanks to bonuses for first-time donors, regular and frequent donations, and the use of less busy times, the compensation can increase to an average of around € 30. Bonuses can also be paid for successfully recommending new donors.
Outlet / inlet cannula with Luer lock in the crook of the right arm, with needle protection and hose clamp
Plasmapheresis device, changing digital display line at the top, hose layout plan 3 hose pumps ...
Approximately 170 ml tank that is filled and emptied several times
Centrifuge with vertical axis of rotation for the continuous separation of yellowish plasma from deep red whole blood in the flow
Bag of blood plasma, hanging on a weighing hook
The duration of the donation depends on the hemoglobin value . The higher this is, the longer the removal process takes. With a donation, 650–850 ml of blood plasma can be withdrawn, depending on body weight.
There must be at least two donation-free days between two donations. Since the amendment of the guidelines of the German Medical Association in 2017, up to 60 plasma donations can be carried out within one year, provided that the guideline values for hemoglobin , immunoglobulin G and total protein are observed, according to the guidelines for hemotherapy.
The donated blood plasma is stored frozen for 4 months at below −30 ° C ( quarantine storage ) and the donor continues to be examined for diseases, for example in the context of further donations. If no blood plasma-transmitted diseases such as syphilis , HIV or hepatitis can be detected in him, his blood plasma donation will be used, otherwise it will be destroyed.
Process of a donation, apparatus
The dispenser is placed on a couch. The support for the elbow and forearm is set up so that the donor can keep the crook of the arm up. In connection with the height of the bed, authorized personnel can stand up and place the cannula in a vein, in short: "prick".
Uniform plasmapheresis machines stand on rollers that can be moved to the side of the head section on the side of the arm to be stabbed. Both sides of the couches are accessible, there is usually exactly one machine at the end of the aisle, creating rows of right or left donor beds. Only in exceptional cases is a donor stabbed roughly on the left and the machine is on the right, because the tube runs impractically across the center of the donor's body.
Before making a donation, the donor needs enough sleep, light food and plenty of water as a drink. Food rich in fat must be avoided as fat droplets in the blood (visible in the cloudiness of the plasma) interfere with the separating function of the centrifuge sieve.
After registering with blood pressure measurement and weighing of body weight (clothed), filling out a questionnaire, possibly a personal examination by a doctor, the client is on hold with his docket. After being called, he is asked about his well-being and his wish-back side. He sits down and lies down on an assigned lounger, which is covered with fresh paper in the area of the head and shoes, and frees the arm concerned. Personnel set up the armrest and arm, which are also paper-based. As a rule, the machine has already been equipped with the disposable "dispensing set" (tubes, centrifuge, tank, collection bag; 2 Luer connections) and an infusion bag with calcium citrate solution .
After wiping and disinfecting the crook of the arm, authorized personnel initiate the inflation of the cuff surrounding the upper arm by pressing a start command on the machine, which creates the blood congestion in the arm veins. A vein is selected by palpation and by sight - from regular donors, people repeatedly remembering something like a map of the veins - and - according to the skin - pierced.
By opening the hose clamp, one or more previously individually labeled sample tubes for blood analyzes are filled and attached to the plasma bag. The blood sugar content is determined with a drop on a sample sheet in a small analyzer that is on the "serving trolley" that has rolled over.
In the next step, the cannula set glued to the forearm is connected to the donation set using a Luer. With a command to the machine, blood is drawn in up to 10 cycles with separation of plasma and the return of residual blood. Calcium citrate is added to inhibit coagulation. The donor receives a small cup of water, possibly magnesiumhältige shower and a few pieces on request dextrose to the release of glucose balance.
The donor is supposed to promote the venous blood flow by activating the forearm muscles by "pumping" - rhythmic clenching of the hand on the donor arm - during the blood collection phase. If the targeted plasma volume - approximately determined by continuously weighing the collection bag - has been reached, or if a maximum duration has been exceeded, the machine makes one last blood return, after which the centrifuge and most of the tubes are also rinsed blood-free and the donor still receives a remaining infusion to replace the removed volume of liquid.
After removing the needle, a pressure bandage is applied to the donor, which ideally runs crosswise on both sides of the elbow to allow good mobility of the joint. Immediately after the donation, the donor can and should - if necessary - remain lying down for a while to allow the blood circulation to start up again. Sitting down and resuming physical activity at a leisurely pace is also recommended. Care should be taken both when getting up and when participating in traffic after the donation.
During the donation, donors read newspapers and magazines that have been opened, books they have brought with them or use smartphones - also with one hand. Around 2000, the use of cell phones was still forbidden because of the risk of radio interference , particularly on the plasmapheresis device.
In the long term, plasma donation requires adequate and protein-rich nutrition. Drinking plenty of fluids in the hours before the donation promotes the washing of metabolic waste products from the body and blood. Regular donation is a certain strain on the body, tolerance of which can also be learned.
Donation Frequency
Austria: After a donation, another donation cannot legally begin until exactly 72 hours at the earliest. The third donation in a sequence can only be made after one week, i.e. on the 7th day after the day of the first donation. In the long term, there is a limit of 50 donations per rolled year, i.e. the past 365 or 366 days. (As of 2017 Austria)
Germany: Plasma can be donated up to twice a week. Donations may be made up to 60 times per rolled year. A donation break of at least 48 hours must be observed. (As of 2019 Germany)
Mexico / USA: The film "Blood Trade - Dollars Against Health" by Stefanie Dodt on October 7, 2019 on ARD provided information about the problems associated with frequent plasma donations. The focus was on the practices by which US companies induce Mexicans, in particular, to donate plasma very often for payment of 300 to 400 dollars a month; the regulations prescribed in Germany on significant side effects and precautionary measures are often ignored.
Hygiene and safety
Strictly executed procedures for hygiene serve the safety of the donors and the staff as well as the quality assurance of the obtained raw material plasma and thus the recipient of the products obtained from it. This includes sterile disposable material from the cannula to the collecting bag, wiping disinfection of the couch and device after (and before) every donation, wearing protective goggles or glasses for all processes in which blood or plasma could splash and disposable gloves from touching the skin of the Donor.
To be on the safe side, a doctor is always present at the donation facility. First-time donors, including those who donate again for the first time after a long period, are given special care. Less plasma is taken from you. In the course of a donation or when getting up afterwards, dizziness, a clouding of the sense of sight or even a clouding of consciousness rarely occur. All donors are therefore under close scrutiny, and staff intervene quickly if they are suspected. A bit of tiredness after a donation is to be tolerated, since the addition of the extracted blood components means work for the body. The mostly mild cases can be cured by sitting down or lying down and resting a little. The administration of common circulatory drugs to raise blood pressure or an infusion is one of the very seldom necessary measures.
Furthermore, special, trained routines apply in the event that a room evacuation should be necessary in the event of a fire, similar to the situation in hospitals, where patients with a connected venous cannula can also lie in bed.
See also
Web links
Individual evidence
- ↑ Medicine explains: Plasma - The gold in your veins , Aponet.de , September 1, 2015
- ↑ Guideline Hemotherapy
- ↑ German Medical Association : Guidelines for the collection of blood and blood components and for the use of blood products (haemotherapy) 2017
- ↑ Tel. Information: Plasma donation service Graz, Citypark, plasma.at ( Memento of the original dated December 2, 2017 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. , December 1, 2017.
- ↑ Plasma Center Heidelberg [1] , April 19, 2019.
- ↑ Video: Bluthandel , daserste.de , October 7, 2019
- ↑ Medicine: The Blood of the Border , sueddeutsche.de , October 4, 2019
