Systemic lupus erythematosus (Lupus) is a chronic autoimmune condition where the immune system mistakenly attacks the body’s tissues and organs. Plasma donation, or apheresis, separates blood components, collects the plasma, and returns the remaining blood cells to the donor. This article examines the regulatory standards and medical reasons that influence donor deferral for individuals diagnosed with Lupus seeking to donate plasma for therapeutic use.
Donor Eligibility and Autoimmune Conditions
Individuals diagnosed with Lupus are typically deferred from donating plasma intended for transfusion or manufacturing therapeutic products. This deferral follows standard regulatory guidelines, such as those set by the U.S. Food and Drug Administration (FDA) and the AABB. Lupus is classified as a chronic, systemic autoimmune disease that generally leads to permanent ineligibility for donation to the public blood supply.
The primary reason for this restriction is to protect both the prospective donor and the recipient of the plasma product. While some centers may accept whole blood from individuals with stable chronic illnesses, the requirements for plasma donation are often stricter due to the nature of the collected product. This definitive deferral for systemic autoimmune diseases serves as an important safeguard for the overall safety of the blood supply.
Risks to the Donor During Plasma Collection
The physical process of plasma collection, known as plasmapheresis, presents potential risks to an individual with a systemic disease like Lupus. Plasmapheresis involves withdrawing blood, separating the plasma, and then returning the remaining blood components. This procedure can place temporary stress on the cardiovascular system due as a result of the extracorporeal circulation of blood and the fluid shifts involved.
The use of an anticoagulant, typically citrate, to prevent the blood from clotting in the machine is also a concern. Citrate binds to calcium in the donor’s blood, which can sometimes cause temporary side effects like tingling or lightheadedness. For a person with Lupus, who may already have underlying issues affecting the heart, kidneys, or blood cell counts, this physiological stress could potentially increase the risk of a disease flare-up. An exacerbation of symptoms could include renewed fatigue, joint pain, or even complications affecting organ systems.
Concerns Regarding Plasma Product Quality
The core concern regarding plasma donated by an individual with Lupus relates to the quality and safety of the final plasma product for the recipient. Lupus is fundamentally characterized by the presence of autoantibodies, which are immune proteins that target the body’s own healthy cells and tissues. These autoantibodies, such as anti-double-stranded DNA (anti-dsDNA) antibodies, would be present in the donated plasma.
Although donated plasma undergoes processing and screening, the transfer of these active immune components to a vulnerable recipient, such as someone who is immunocompromised, is a major medical concern. Furthermore, the medications used to manage Lupus often include potent immunosuppressive drugs, like mycophenolate mofetil (CellCept) or corticosteroids. The presence of these residual drugs in the donated plasma is considered unacceptable for therapeutic products.
Alternative Ways to Support Blood Banks
While plasma donation for general therapeutic use is restricted, individuals with Lupus have alternative avenues to contribute to medical science and support blood banks. Some specialty centers actively seek plasma donations from individuals with autoimmune conditions like Lupus for research purposes. This particular plasma is used to develop diagnostic tests and advance understanding of the disease.
Other impactful ways to support the mission of blood and plasma centers include non-medical contributions. People can volunteer their time to help organize blood drives or assist with administrative tasks at donation centers. Financial donations are always needed to support the operational costs of collection, testing, and distribution. Advocating for the importance of blood donation within their community also serves as a meaningful way to contribute.