India’s first plasma bank was set up at the Institute of Liver and Biliary Sciences (ILBS) on July 2 to ease access to plasma that is being used to treat Covid-19 patients. The lack of treatment options for COVID-19 necessities plasma therapy as an option to control the virus.
Following the developments, the government of Assam, on July 16 last, decided to invite plasma donors from all over the country in a bid to carry forward its policy of ‘aggressive treatment’ of Covid-19 patients as stated by Health Minister, Himanta Biswa Sarma. Sarma added that donors from other states will be treated as state guests with free return airfare and stay and people donating within the state will also be "preferred in government schemes and they may get preferential allocation of houses under PM Awas Yojana. Society should acknowledge their contribution."
Following July, cases in the state have risen from 19,754 positive cases with 12,888 recoveries and 48 deaths to 1,18,333 positive cases with 88,726 recoveries and 330 deaths as on 4th September. This has created the need for more plasma donations and awareness.
Dr Dipankar Baruah who is heading the plasma bank in Gauhati Medical College & Hospital (GMCH) spoke to G Plus where he raised the issue of more awareness and campaign regarding the need for plasma donation in a bid to fight COVID-19.
The following explainer seeks to inform the basic know-how regarding the plasma donation
What is Plasma Therapy?
Plasmapheresis is a process in which the liquid part of the blood, or plasma, is separated from the blood cells. Typically, the plasma is replaced with another solution such as saline or albumin, or the plasma is treated and then returned to your body.
Plasma therapy is a medical procedure that uses the blood of a recovered patient to create antibodies on infected individuals. Medically known as convalescent plasma therapy, this treatment uses antibodies found in the blood taken from a recovered Covid-19 patient. It is then used to treat those with severe SARS-CoV-2 infection (or Covid-19) to aid recovery.
What is the difference between plasma and blood bank?
A plasma bank functions like a blood bank and has been created specifically for those who are suffering from Covid-19, and have been advised the therapy by doctors. The current blood bank health professionals of GMCH are now engaged with the plasma bank work.
2009: It was used in the treatment of H1N1 infection in 2009.
2014: The World Health Organisation (WHO) recommended the use of plasma therapy to treat Ebola patients.
2015: It was also recommended to treat the Middle East Respiratory Syndrome (MERS) which is a type of corona virus.
2020: US Food and Drug Administration (FDA) authorized convalescent plasma therapy for people with corona virus disease.
Where can we donate plasma in Assam?
Plasma can be donated in a plasma bank set up by the government. In Assam, GMCH in Guwahati is operating and talks are ongoing to introduce the same in all state medical colleges. As per Assam Health Care, which has been handling the plasma donation, no such updates have come to introduce donations outside GMCH to other nursing homes. To know the nearest centre, one can call 104 or 0361-2558955 or email to osd.nhm1.assam@gmail.com
Who can donate the plasma?
Previously symptomatic patients who have suffered from COVID-19 can donate plasma. The definition of ‘symptomatic’ varies. In recent times, even gastritis and other such symptoms have also been considered, as informed by the GMCH plasma bank. A complete pre-test is done to ascertain eligibility.
Other general parameters: The donor should have 12.5 and above hemoglobin. Hypertension should be under control. If the donor has diabetes, he/she should not be on insulin. If on an antibiotic, then there should be a 72 hours’ gap. If he/she has donated plasma, they can donate again after 2 weeks.
Who are exempt from donating plasma?
The age limit of a donor is 18-60 and his/her weight should be minimum 55 kgs. Donor should not have any chronic disease like tuberculosis, cirrhosis, renal and other similar chronic diseases. If the patient has had tooth extraction, then he/she cannot donate for 6 months.
In females only Nulliparous females are accepted for the plasma donation. Nulliparous is the medical term for a woman who has never given birth either by choice or for any other reason. This term also applies to women who have given birth to a stillborn baby, or a baby who was otherwise not able to survive outside the womb. Multifarious females cannot be donors of plasma because such females have antibodies which can lead to transfusion-related acute lung injury (TRALI). Unmarried females who have no children can also donate.
What are the pre-requisites for donating plasma?
Blood group match for donor and recipient. Donor should be fit in all criteria for a blood donation. The Assam government does an antibody test for immune response and along with that tests for hepatitis among others is also done. A proper SOP is followed which maps the history of the donor.
If the donor's result of COVID-19 test is negative, then after 14 days there will be a re-test of the COVID and antibodies and after that the donor can donate plasma. In Assam, following 14 days RT-PCR is done. If the individual has recovered and crossed a 28-day period, then a re-test for COVID is not required. However, in GMCH, additional truenat test may also be done.
What is the cost of plasma therapy in Assam?
Any patient staying in a nursing home who wishes to take plasma from GMCH will have to pay for the plasma kit but not for the plasma. The cost will be around Rs 6,500. But patients already getting treated in the state medical colleges need not pay for the kit.
What is the time taken to complete the process?
In GMCH, after tests and corresponding results from various departments, the entire process takes about 3-4 hours.
What are the risks for plasma therapy?
Immune-mediated reactions are most common as these include allergic and anaphylactic reactions, TRALI, and haemolysis. The process needs to done in continuous supervision to avoid in procedure problems.
