The question of whether an individual with Postural Orthostatic Tachycardia Syndrome (POTS) can donate plasma is a common concern for those with the condition who wish to contribute. POTS is a disorder of the autonomic nervous system that causes an abnormal increase in heart rate upon standing, leading to symptoms like lightheadedness, fatigue, and brain fog. Plasma, the liquid component of blood, is a life-saving resource used to create therapies for immune deficiencies, bleeding disorders, and other critical conditions. Because the donation process directly impacts the circulatory system, understanding the underlying physiology of POTS is necessary to address eligibility.
Understanding POTS and Volume Regulation
POTS is characterized by the autonomic nervous system’s failure to properly manage heart rate and blood pressure changes when a person moves to an upright position. The defining feature is a sustained increase in heart rate of at least 30 beats per minute within ten minutes of standing, without a significant drop in blood pressure. This excessive tachycardia is the body’s attempt to compensate for poor circulation.
A significant number of people with POTS experience hypovolemia, a lower-than-normal total blood volume circulating in the body. This reduced volume, particularly of the plasma component, makes it harder for the body to maintain stable blood pressure and adequate blood flow to the brain when upright. Consequently, a primary management strategy for many POTS patients involves actively increasing fluid and salt intake to boost blood volume.
The body’s regulatory systems, including hormones like renin and aldosterone, may function improperly in POTS, contributing to this volume deficit. This pre-existing state of volume instability is a factor when considering any procedure that involves fluid removal from the body. The hypovolemic state already strains the circulatory system, which is why symptoms are often worse upon standing or in the heat.
Physiological Impact of Plasma Donation
Plasma donation is a procedure where whole blood is drawn, the plasma is separated, and the remaining blood components are returned to the donor. Plasma constitutes about 55% of total blood volume, and its removal causes an acute, temporary drop in the overall fluid volume within the circulatory system.
This process results in temporary hypovolemia and circulatory stress, even in healthy donors. Common side effects include temporary lightheadedness, fatigue, and dizziness, which are directly related to the fluid loss. The body immediately begins to regenerate the lost plasma, typically restoring levels completely within 72 hours.
To mitigate the effects of this volume reduction, donors are advised to hydrate extensively before and after the procedure. While a healthy body recovers quickly from this temporary fluid imbalance, the physical impact of donation represents a significant challenge to the body’s ability to regulate fluid balance and blood flow.
Official Guidelines for Chronic Illness Donors
Plasma donation centers operate under strict guidelines to ensure the safety of both the donor and the plasma recipient. Eligibility rules screen for chronic medical conditions that could compromise the donor’s health during the procedure. Donors must be in good health, pass a medical screening, and meet specific criteria for vital signs.
A diagnosis of a chronic illness like POTS frequently leads to deferral or permanent disqualification at many donation centers. This policy stems from the inherent instability of the condition, particularly its link to reduced blood volume and circulatory control. Many centers require that donors do not have a chronic condition requiring ongoing treatment that might be affected by the donation process.
Even if a person with POTS feels well, factors like a high resting heart rate or blood pressure readings outside the acceptable range at the time of screening can result in immediate deferral. Because the guidelines prioritize donor safety, the potential for an adverse reaction in a patient with a known disorder of orthostatic tolerance often makes them ineligible. A permanent deferral is the common policy at major plasma collection facilities.
Specific Safety Concerns for POTS Patients
The temporary hypovolemia caused by plasma donation poses a significantly heightened risk for individuals with POTS. The procedure removes a substantial amount of plasma, which directly worsens the pre-existing low blood volume common in this patient population. This acute loss can push an already compromised circulatory system past its limit, leading to severe symptom exacerbation.
The primary concern is the increased risk of orthostatic intolerance and syncope, or fainting. For a person with POTS, the volume depletion can cause a severe symptomatic “crash,” potentially resulting in a prolonged flare-up of dizziness, fatigue, and brain fog. The recovery time can be significantly extended compared to a healthy donor, potentially lasting days or even weeks.
The donation process requires the circulatory system to work harder to restore the lost fluid, placing additional strain on the heart. For a POTS patient whose heart rate already excessively increases upon standing, this added stress can be dangerous. The risk of a severe adverse event, such as a major syncopal episode or hypovolemic shock, is considered too high by most medical professionals and donation centers.