Original Article

Source Plasma Donation: The Experience of the Iranian Blood Transfusion Organization


Background: A declining need for red blood cells coupled with strengthening demand for plasma-derived medicines has led to a strong focus on moving whole blood donors to plasmapheresis. The purpose of this study was to evaluate the four-year policies of the Iranian Blood Transfusion Organization (IBTO) in terms of plasmapheresis recruitment of first-time donors and its effect on plasmapheresis outcome.  

Materials and Methods: Plasmapheresis data related to 16 centers from 2016 to 2019 was obtained from IBTO software. This information includes; (1) blood donation number, (2) plasmapheresis donation number, (3) number of plasmapheresis donors, (4) plasmapheresis donor demographic data, (5) plasmapheresis donor status, (6) frequency of plasma donation for each donor, (7) volume of plasma and (8) the prevalence of transfusion-transmissible infections (TTIs) in plasmapheresis donors.

Results: The result of this study demonstrated that plasmapheresis collection centers have recruited 85,515 (91%) first-time and 8,595(9%) regular and repeated donors from 2016 to 2019 years. Plasmapheresis to blood donation index was increased from 0.2% in 2016 to 4.9% in 2019. The mean donation number was 2 times per year. The trend of the yearly Whole Blood Donation (WBD) Index decreased from 26.69 to 24.11/1000 for the general population. The total volume of collected source plasma was 49,203 liters during this period. However, 46,000 liters of recovered plasma were decreased due to less WBD. Furthermore, the results indicated that the prevalence of HCV was significantly higher in first-time donors compared to repeated and regular donors (P = 0.000).

Conclusion: It is concluded that during four years, the net volume of plasma did not increase and plasmapheresis led to reducing WBD in our country. Moreover, first-time plasmapheresis donors can be associated with challenges such as increasing screening costs and compromising the safety of plasma resources. Therefore IBTO decided to stop the project and focus on its main role to prepare safe and sufficient blood components through WB collection and also single donor platelet and concurrent plasma by plateletpheresis.


1. Burnouf T. Modern plasma fractionation. Transfus Med Rev. 2007;21(2):101-17.
2. Health Canada R. Protecting access to immune globulins for Canadians: Final report of the expert panel on immune globulin product supply and related impacts in Canada. Available at https://donationethics.com/static/IGReport.pdf, p.23, 2018.
3. Economist, T., Americas booming blood-plasma industry: Paid- for plasma is both less exploitative than often recognised, and invaluable. Available at https://www.economist.com/international/2018/05/10/americas-booming-blood-plasma-industry., 2018.
4. Robert P. International directory of plasma fractionators. 2012.
5. Rader AW, France CR, Carlson B. Donor retention as a function of donor reactions to whole‐blood and automated double red cell collections. Transfusion. 2007;47(6): 995-1001.
6. Garrioch M. The body's response to blood loss. Vox Sang. 2004;87 Suppl1:74-6.
7. Amrein K, Valentin A, Lanzer G, et al. Adverse events and safety issues in blood donation—a comprehensive review. Blood Rev. 2012;26(1):33-42.
8. To L, Dunnington T, Thomas C, et al. The United States' potential blood donor pool: estimating the prevalence of donor‐exclusion factors on the pool of potential donors. Transfusion. 2020; 60(1): 206-215.
9. Committee, A.P.F.R. and P. Flood, Review of Australia's plasma fractionation arrangements. 2006: Department of Health and Ageing.
10. National Blood Authority and Australian Healthcare Associates (AHA) Pty Ltd. Fresh blood products: production benchmarking and demand drivers, 2007.
11. Eichbaum Q, Martin Smid W, Crookes R, et al. Apheresis in developing countries around the World. J Clin Apher. 2015;30(4):238-46.
12. Bagot KL, Bove LL, Masser BM, et al. Perceived deterrents to being a plasmapheresis donor in a voluntary, nonremunerated environment. Transfusion. 2013. 53(5): 1108-19.
13. Bechtloff, S., et al. A prospective trial on the safety of long‐term intensive plasmapheresis in donors. Vox Sang. 2005; 88(3):189-95.
14. Rodell MB, Lee, ML. Determination of reasons for cessation of participation in serial plasmapheresis programs. Transfusion, 1999. 39(8): 900-3.
15. Schulzki T, Seidel K, Storch H, et al. A prospective multicentre study on the safety of long‐term intensive plasmapheresis in donors (SIPLA). Vox Sang. 2006. 91(2): 162-73.
16. Davison, TE, Masser BM, Gemelli CN. Deferred and deterred: a review of literature on the impact of deferrals on blood donors. ISBT Sci Ser. 2020. 15(1): 3-10.
17. Organization WH. Towards self-sufficiency in safe blood and blood products based on voluntary non-remunerated donation. Global Status, 2013.
18. Masser BM, Bove LL, White KM, et al. Negative experiences and donor return: An examination of the role of asking for something different. Transfusion. 2016;56(3):605-13.
19. Nair SC, Mammen JJ. Repeat voluntary non-remunerated blood donor is the best quality indicator for blood safety. Indian J Med Res. 2015;141(6):749-52.
20. English W, Jaworski PM. The Introduction of Paid Plasma In Canada and the US Has Not Decreased Unpaid Blood Donations. 2020. Available at SSRN: https://ssrn.com/abstract=3653432.
21. Farrugia A, Penrod J, Bult JM. Payment, compensation and replacement–the ethics and motivation of blood and plasma donation. Vox Sang. 2010. 99(3): 202-211.
IssueVol 16, No 3 (2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijhoscr.v16i3.10137
Donor recruitment; Plasmapheresis; Plasma fractionation

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Mohammadi S, Aghabozorg F, Balagholi S, Ferdowsi S, Sharifi S, Eshghi P. Source Plasma Donation: The Experience of the Iranian Blood Transfusion Organization. Int J Hematol Oncol Stem Cell Res. 2022;16(3):151-156.