‘Anyone who has ever been pregnant can’t donate plasma’: ILBS director
A person can donate plasma after 14 days of recovery only if they are not older than 60-65 years of age, do not have uncontrolled diabetes or hypertension, do not have chronic kidney, heart, lung, or liver disease.
Dr SK Sarin, director of the Institute of Liver and Biliary Sciences (ILBS), spoke to Anonna Dutt about plasma therapy and the creation of the new plasma bank in the Capital. Edited excerpts:
Why did Delhi decide to set up a plasma bank? The Indian Council of Medical Research (ICMR) still classifies it as an experimental treatment.
Earlier the therapy could be administered only under clinical trial that very few institutes were conducting. The Union health ministry has now allowed the off-label use of convalescent plasma therapy, meaning many more hospitals can start administering it to patients who fit the criteria (those with moderate disease whose oxygen requirement keeps increasing despite being given oxygen and steroids). Patients were finding it difficult to get donors as it is and with more and more people looking for donors it may lead to unethical practices of demanding money. With the government setting up the plasma bank, people will know where to get it from.
Who is eligible to donate?
The most important thing is to not harm the donors in any way. To ensure that, there are very strict guidelines in place. A person can donate plasma after 14 days of recovery only if they are not older than 60-65 years of age, do not have uncontrolled diabetes or hypertension, do not have chronic kidney, heart, lung, or liver disease. The donors should also be well nourished and above 50kg weight. Their haemoglobin levels also have to be over 8. Women who have ever been pregnant are also excluded as donors. And, their antibody levels must be good.
The good thing about plasma donation is that one component of the blood is taken and a person can donate it again in 15 days.
Why can’t women who have been pregnant donate plasma?
Yes, anyone who has ever become pregnant is excluded from plasma donation for Covid-19. A baby contains genetic material from both the mother and the father. So, when a woman gets pregnant, she develops antibodies against the father’s genetic material [human leucocyte antigen]. This HLA antibody can lead to a transfusion related complication called Transfusion related acute lung injury (TRALI). Covid-19 patients already have compromised lungs, plasma with HLA antibody might increase their chances of lung damage.
Do you also screen donors based on the Covid-19 antibody levels?
Yes, at ILBS we look for two things – one is the level of the antibody IgG and the other is neutralising antibody. As per the protocols, we look for an IgG titre of 1:640 meaning high levels of this antibody. Now, some of these antibodies – not all -- work by neutralising the Sars-Cov-2 virus that causes Covid-19. We check for these neutralising antibodies.
Will you be accepting plasma from other centres?
No. This is a plasma bank and other hospitals can ask for plasma as per their need. If they do get donors, the plasma can be utilised at the centre itself. Currently, there is a scarcity of donors, so nobody really has surplus. We will only be accepting donations at this centre and storing it.
Who pays the processing cost of the plasma?
Once we receive a donation, we need to check the plasma for transfusion transmitted infections such as HIV, Hepatitis B and C. Then the antibody levels are also checked. The filter for the apheresis to separate the blood components costs about Rs 6,000 to 7,000. Then, there is the cost of plasma bags, storage. In total, the cost comes up to Rs 10,000 to 12,000. And, this is excluding the HR and infrastructure cost. This cost will be borne by ILBS or the Delhi government. The plasma will be available free to the patients.
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