COVID-19: Why Some Women are Not Eligible for Plasma Donation

Women who have been pregnant cannot donate convalescent plasma for treating COVID-19 infection. According to the new study, women develop antibodies called human leucocyte antigens (HLA) during pregnancy, against the father’s genetic material. The embryo has a genetic component from the father as well, so in response to this foreign element the mother's immune system generates these antibodies. Higher HLA count is necessary for higher rates of success during pregnancy. But HLA can cause severe complications in recipients. The HLA antibodies can cause a rare, but serious complication known as plasma Transfusion-Related Acute Lung Injury (TRALI) in transfusion recipients.

TRALI is an acute complication characterized by severe shortness of breath, fever and low blood pressure. It is one of the most common causes of transfusion-related death. TRALI can occur rapidly after a blood transfusion and is often associated with the receipt of plasma or platelet products.

Convalescent plasma is the liquid part of blood that has antibodies against the infection from which patients are recovering. Plasma transfusion not a new concept, it has been applied since the flu pandemic in 1918. Plasma therapy infuses plasma containing antibodies of recovering patients into sick patients, to fight the infection, before their own immune system kicks in.

In the case of SARS-Cov-2, it has become a sought-after therapy to cure people suffering from the infection. A person who has recently recovered from COVID-19 develops antibodies against SARS CoV 2 virus. Their plasma containing the antibodies is collected and transferred to a sick patient. A person can donate 250-500 ml of plasma. As a first dosage, 250 ml is given to the recipient, and if needed, a second dosage of 250 ml after 24 hours can be given.

But, there are certain criteria among the plasma donors. They have to be above 18 years and below 60 years, should be free from lung, kidney, heart, or liver disease. They should not have diabetes, and their blood pressure needs to be not more than 140 and diastolic not less than 60 or more than 90. They should weigh at least 50 kgs. More importantly, they can only donate plasma after a minimum of 14 days from recovery.

Women with a history of pregnancy cannot donate plasma. This is because once developed, the HLA remains in the blood forever. They are however, not harmful to the people who make them.

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But since COVID-19 infection weakens the lungs in patients, transfusing the plasma of a woman who has been pregnant, could prove fatal. Therefore, women with pregnancy history are not eligible to donate if they are not tested for HLA antibodies.

Source-Medindia