Blood, Plasma or What?

I often get the question, why are you asking for blood donations when you are receiving plasma?

Plasma is the liquid portion of blood. A protein-salt solution in which red and white blood cells and platelets are suspended. Plasma constitutes 55 percent of blood volume and is 92 percent water. 

The blood can be separated into red blood cells, white blood cells, platelets and plasma. This allows donations of specific blood parts. It also allows replacement or treatment to those parts. 

With Thrombotic Thrombocytopenic Purpura (TTP), the platelets are destroyed due to antibodies in the plasma. The body's bone marrow is still capable of generating platelets. The issue is the new platelets will also get destroyed. Eventually, the body will not have enough platelets, bringing on symptoms and consequences. 

Part of the TTP solution is to replace the bad plasma with good plasma using plasmapheresis. The process is done by removing the blood, separating out old plasma, adding in new plasma, and returning the blood. The new plasma will allow platelets to increase and better blood markers should result the next day.

Plasma can be provided in the following versions: 

• Fresh frozen plasma (FFP): FFP comes directly from a few blood donors and can be used for plasmapheresis 
• Cryosupernatant: a version of plasma with reduced levels of factor VIII, von Willebrand factor, factor XIII, fibronectin and fibrinogen. Cryosupernatant plasma can be used when replacement of FVIII is not required, and is indicated for plasmapheresis for patients with TTP or HUS. 
• Solvent detergent plasma (S/DP): a version of plasma pooled from thousands of donors and the processed with solvents and detergents to remove viruses and reduces the risk of allergic reactions. I call this the Tide plasma. In many cases TTP patients may have allergic reactions to FFP or Cryosupernatant; S/DP may resolve this risk.

In my case, I am special, special! I have chronic TTP which impacts 3 in one million people a year. I am also anaphylaxis to plasma transfusion. In other words, I am allergic to FFP and Cryosupernatant, so I need S/DP.  

My apheresis nurse just reminded me, in 2012, she was the first nurse in Canada to provide S/DP and I was the first patient. S/DP is now available for all patients who require it. 

Thanks, Bruce.   

@BruceFightsTTP