Plasma therapy: Hospitals ask for replacement donors

While demand increases, doctors say there has been poor response from COVID-19 recovered patients to donate

Last week, the family of a 74-year-old critical COVID-19 patient had to scout for a suitable plasma donor as the plasma bank that had a stock matching the patient’s blood group asked for a replacement donor. This was even as the patient’s condition was deteriorating and the family was making one last-ditch effort with plasma therapy.

Amidst the debate over its effectiveness, the demand is actually increasing for convalescent plasma therapy, which is the use of antibody-rich blood plasma from a recently recovered patient to boost a critical person’s immune system.

However, as not all recovered patients can donate, it is hard for the distressed families to find a suitable donor during the crisis. On the other hand, doctors say that a poor response from recovered patients has made it inevitable for hospitals to demand for replacement.

Most private hospital blood banks authorised to take up plasma therapy in the city admitted that they were asking for replacement donors as it was “essential to keep the chain going.” While some hospitals give the patient a week’s time to get the donor, some others ask for immediate replacement.

“Although over 6.5 lakh patients have recovered, not even 0.5% of them have come forward to donate. Most recovered persons are either not willing to donate or feel it is unsafe for them to go out to a hospital to donate. Also, most are worried that their immunity level might reduce after the donation, which is a misconception,” said U.S. Vishal Rao, who heads the State-supported HCG plasma bank.

“Although we have given out 900 units so far, we have had only 500 plasma warriors who came forward to donate. Ideally patients can donate plasma every two weeks. While we need 200 ml for each therapy, we usually draw around 450 ml. The demand-supply gap is growing and unless there is replacement, we cannot keep the chain going. While we ask for immediate replacement, we do not hold the treatment of the patient if plasma is available,” said Dr. Rao. C. Shivaram, Consultant and Head of Transfusion Medicine at Manipal Hospitals, said, “We request the families of patients who undergo the therapy in our hospital to get a replacement donor within a week. Although we have been creating awareness about the need to donate, hardly 25% of our donations are through replacements. The rest are through healthcare workers, including doctors, nurses and technicians,” he said.

Safe to donate

Pointing out that an adult donor has three litres of plasma in him, Dr. Shivram said, “Out of this only 200 ml is expected to be enough to treat a patient. Whether one donates or not these antibody levels will go down in about three to four months. The good thing, however, is that the memory cells in the immune system that, when exposed to an invading pathogen, replicate and remain in the lymph nodes searching for the same antigen, resulting in a more efficient and rapid response to any subsequent attack,” he explained adding that it is safe to donate if the person has a good antibody level.

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