Plasma and plasma products
Adverse reactions that you could experience after you receive a plasma transfusion include:
- a slight rise in temperature
- itching and sometimes a rash (hives) – this can occur within a few minutes of starting to receive a plasma transfusion, but can usually be cured by slowing down the rate of transfusion or by taking an antihistamine (medication to treat mild allergic reactions)
- anaphylaxis – this is a rare but life-threatening allergic reaction
The risk of developing an infection after receiving plasma is very small. All blood donations that are used to make plasma have to be carefully screened for viruses to make sure they are safe.
However, as is the case with most medical procedures, there are some possible risks associated with receiving plasma. These are briefly outlined below.
Transfusion-related acute lung injury (TRALI)
Transfusion-related acute lung injury (TRALI) is a reaction that can occasionally occur in someone who receives a plasma transfusion. The person will have breathing difficulties during or shortly after the transfusion, which can sometimes be severe.
The reaction is thought to occur because the donated plasma contains antibodies (proteins produced by the donor's immune system), called HLA antibodies, that react with the recipient's white blood cells. The plasma will have been donated by a female who has been pregnant in the past and whose immune system produced the antibodies as a response to the pregnancy.
Antibodies are normally produced by the immune system to fight organisms in the blood that the body regards as "foreign", such as bacteria, but in pregnancy they have a protective role.
To minimise the risk of TRALI occurring, plasma from male donors is usually used to make fresh frozen plasma and other plasma-containing blood products that are used for transfusion.
Pooled plasma for transfusion and fractionated plasma products do not cause TRALI.
Variant Creutzfeldt-Jakob disease (vCJD)
Variant Creutzfeldt-Jakob disease (vCJD) is the human form of bovine spongiform encephalopathy (BSE), which is commonly known as mad cow disease. First identified in 1996, vCJD is a rare, neurological illness that causes brain damage. It occurs as a result of eating the meat of cattle that are infected with BSE.
The risk of developing vCJD after having a blood transfusion is very small, but there is currently no test available to screen blood for the prion protein that causes vCJD.
Each year in England, approximately two million units of blood are transfused. To date, there have only been a few cases where patients are known to have become infected with vCJD after having a blood transfusion.
However, to minimise the risk further, the NHS has put a number of further precautions in place. These include:
- removing all white cells by filtering cellular blood components (red blood cells and platelets)
- importing fresh frozen plasma (FFP) for transfusion to those born after January 1 1996 from countries where there have been no cases of vCJD
- using pooled plasma for fractionation from countries where there have been no cases of vCJD, and using recombinant clotting factors (produced in a laboratory using DNA technology) for treating haemophiliacs, where these products are available
- only using plasma transfusions when absolutely necessary
See the Health A-Z topic about CJD for more information about the condition.
