Giving Tuesday: Plasma Donation for Immunodeficiency

Have you heard of the Bubble Boy 🫧? David Vetter 👦🏻 was born with severe combined immune deficiency, 😷 the most serious of primary immunodeficiencies. Without a functional immune system, he faced the constant threat of infections🦠 that most of us take for granted. For more than a decade, his story unfolded within the carefully controlled environments of Texas Children's Hospital 🏥, capturing the world's attention and empathy. During David's time, the only known cure for SCID was a bone marrow transplant🦴. Tragically, he succumbed to lymphoma in 1984 at the age of 12, believed to be triggered by the Epstein-Barr virus.

Immunoglobulins, or antibodies, play a pivotal role in our body's defense against infections.  Intravenous immune globulin (IVIG) is a blood product derived from the pooled blood donations of 5000 to 50,000 people🩸🩸! This concentrated collection of antibodies helps to fight various infectious organisms our bodies might encounter. IVIG is a lifeline for individuals with both primary and secondary humoral immunodeficiencies, providing the extra antibodies their bodies cannot otherwise make.

Immunoglobulins can be given as IVIG monthly at the hospital or in subcutaneous form, which the patient can inject weekly at home. In both forms, the immunoglobulin replacement is a diverse mix of antibodies that have encountered various germs (like bacteria and viruses), parts of our own bodies, and even counteracting antibodies. For people with no functioning humoral immune systems, this is lifesaving. 🩺

Over the years, we've made remarkable strides in treating humoral immunodeficiencies using immunoglobulins. Back in 1952, Dr. Bruton 👨🏽‍⚕ achieved a breakthrough by successfully treating an 8-year-old boy 👦🏼 with congenital agammaglobulinemia using subcutaneous injections🩼. However, when intravenous immunoglobulin (IVIG) was introduced, it brought along severe side effects such as fever, convulsions, chills, and even vasomotor collapse. Patients thus recieved either subcutaneous or intramuscular injections, which were extremely painful. It was also not efficacious because the dose would be limited by the amount of immunoglobulins that could fit into a syringe. Then, in the 1980s the first intravenous preparations became standardized. Now 40+ years later, immunoglobulins cna be given regularly with minimal side effects and risk of transmissible infections ✔️.

IVIG isn't just a defence against external threats. It also plays a crucial role in autoimmune diseases 🤒, where the immune system mistakenly attacks the body's own cells or proteins. In these cases, IVIG helps regulate the immune response, offering relief and management for individuals facing these complex conditions. Other indications include neuroimmunologic disorders 💪 such as myasthenia gravis, infection related disease such as toxic shock syndrome, and in select cases, for recurrent unexplained pregnancy loss 🐣. Of course though, there is no one size fits all. Each indication has a different dose and protocol.

Right now in Canada, we face major challenges in our plasma supply. 🇨🇦 These include not having enough plasma collection centers and not yet being able to fractionate (e.g. seperate into components) our own immunoglobulins. This means that we must purchase💰 a large quantity of plasma from other countries. At the same time, immunoglobulin replacement makes up the highest percentage of plasma derived products and demand is growing each year.

One of the ways that we can help out 🫶🏼 is to increase our domestic supply of plasma, through donations from people you and me. Here in Canada, donations are competely voluntary and free 👐🏼. Most healthy people can make plasma donations to provide those suffering with immunodeficiencies. It is an easy way to increase our plasma supply and help patients for whom there is no other type of treatment. And in the meantime, we may soon have a plasma fractionation center to meet the domestic demand.😎

Click here to find a donation center. (Canada / Czechia / Egypt / Germany / Hungary / USA / Ukraine)

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Watch this video to see me give my first plamsa donation 📹 

Thank you to:

• Michaela Giang RN for explaining the process of plasma donation.

• Dr Hien Reeves for filming and making possible this rendez-vous at the Canadian Blood Services.

• Dr Bruce Mazer for his feedback and for allowing me to adapt his presentation for this article.

Sources are hyperlinked in text.