Plasma Collection and Donor Safety in Rural China

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Abstract
Blood transfusion is a critical component of modern health care in all parts of the world. Approximately 75 million units of whole blood are collected worldwide, although the amount of available blood varies widely, and 83% of the global population has access to only 40% of the blood supply. The safety of the blood supply is a matter of great concern, and the global expectation is that, at a minimum, every unit of blood should be tested for markers of infection with hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV. Additionally, the World Health Organization and the International Federation of Red Cross and Red Crescent Societies mandate the collection of whole blood from unpaid volunteer donors only, both as a critical ethical requirement and to assure the safety of the blood supply. Neither of these sets of requirements is being met in full in the developing world, although progress is being made toward their complete fulfillment. In addition to the transfusion of whole blood, human plasma is used in the manufacture of derivatives, including albumin and clotting factors. In most countries, the needs for such medications cannot be fully satisfied by plasma recovered during the collection of whole blood, and there is a parallel system for the collection of plasma specifically designated for further processing. It is common to pay the donors of such plasma, even in developed countries. Plasma for further manufacture may be collected in 2 ways. The simplest is to collect a unit of anticoagulated whole blood in a plastic container, separate the cellular elements from the plasma by centrifugation, and express the supernatant plasma into a second container. The cells are then infused back into the donor. The other approach uses a continuous-flow device that automatically separates plasma and returns the cells to the donor—a process termed “plasmapheresis.”

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