Plasma donation, or plasmapheresis, involves drawing blood, separating the liquid plasma component from the solid blood cells, and then returning the blood cells to the donor’s body. While the procedure is generally considered safe and is a major source for life-saving therapies, it is important to understand the potential risks involved. The temporary removal of fluid and proteins initiates physical and internal responses in the donor, ranging from common, mild discomfort to rare, serious complications. Knowing these potential dangers allows donors to take proper precautions and recognize when to seek assistance.
Common Immediate Side Effects
The most frequent reactions are typically short-lived and related to the body’s immediate adjustment to fluid loss. Many people report feeling lightheaded or dizzy during or immediately following the procedure. This is often due to a temporary drop in blood pressure caused by the removal of plasma fluid, which is approximately 92% water.
Some donors may also experience nausea, temporary weakness, or a general feeling of being unwell, collectively known as a vasovagal reaction. In a small percentage of cases, this reaction can progress to fainting (syncope). Staff are trained to manage these symptoms quickly by having the donor rest with their feet elevated and providing fluids and a small snack.
Localized discomfort or soreness at the venipuncture site is also common. Bruising, known as a hematoma, can develop when blood leaks from the punctured vein into the surrounding tissue, causing a visible discoloration.
Risks Related to the Donation Procedure
Complications stemming from the mechanical aspects of the procedure, such as needle insertion and anticoagulant use, are generally rare. Hematoma formation is the most common localized physical issue, occurring when blood pools under the skin near the puncture site. While usually minor, a larger hematoma can cause significant pain and swelling.
A very rare risk is irritation or damage to a peripheral nerve, which can happen if the needle is inserted or withdrawn improperly. This may cause immediate sharp pain, followed by symptoms like tingling, numbness, or a shooting sensation in the arm or fingers. Most nerve irritation resolves completely, but the possibility of a persistent injury exists.
During plasmapheresis, citrate is used to prevent the blood from clotting inside the machine. Citrate works by binding to calcium ions, and a temporary drop in ionized calcium levels can trigger a mild “citrate reaction.” Symptoms typically include a tingling sensation around the mouth, lips, or fingertips, a metallic taste, or chills.
More severe citrate reactions, which can involve muscle twitching, spasms, or cardiac arrhythmias, are exceedingly rare. There is also a minimal risk of a localized infection at the puncture site whenever the skin barrier is breached. Donation centers follow strict sterile protocols, but donors should monitor the site for signs like increased redness, warmth, or swelling.
Internal Physiological Impacts
The process of removing plasma creates temporary, systemic changes in the body that require time for full recovery. Since plasma is mostly water, its removal leads to a temporary state of dehydration and fluid volume depletion, which contributes to feelings of dizziness and fatigue. Maintaining adequate hydration before and after the procedure is important to mitigate these effects.
Plasma contains proteins, including albumin, globulins, and clotting factors. Their temporary removal leads to a reduction in their overall concentration. While the body typically replenishes these proteins, the reduction is more pronounced in frequent donors.
Immunoglobulin G (IgG) levels, which are important for immune function, have been shown to temporarily decrease after donation. However, they generally remain within clinically acceptable ranges when proper donation intervals are followed.
The body needs time to synthesize new proteins and restore fluid balance, which is why regulatory guidelines require recovery periods between donations. This protein and fluid loss can manifest as temporary fatigue or lowered energy levels. Adherence to the recommended recovery time ensures that these internal components return to their physiological baseline.