Risks and Side Effects of Donating Plasma

Making money with plasma donation sounds great, but you probably have a few big questions on your mind before you are ready to start.

  • What are the side effects?
  • Is donating plasma safe?
  • Are there long term impacts?

There are a lot of great things about plasma donation.  You get to help save lives and make some nice money while doing it.  But there are some risks you need to consider. As with any medical process, there is the potential for something to happen during your donation.   You should understand these risks and probabilities before you make your decision.  

If you do have concerns, I highly recommend you talk with your health-care provider based on your specific health situation and concerns.   

Side effects of donating plasma

If you are concerned about the side effects of donating plasma, it’s pretty hard to find good information.  You will usually just find a list of possible risks with a short description. There really isn’t any discussion on the frequency or severity of the reaction, which is what you really need to know.  

Instead of just providing the same list, I will go into much more detail on the side effects of donating:

  • Which side effects are most common
  • What are the more severe reactions and how often do they occur
  • How your specific situation/demographics may impact your experience

What side effects are most common?

The good news is that most donors don’t have issues donating plasma when they are properly prepared.  If a donor experiences some type of reaction, it usually falls into two categories. (Warning, there will be some medical jargon used, but I will do my best to translate it into plain English).  

Vasovagal reaction: 

dizzy lightheaded faint plasma donation
  • This is a fancy term for when you feel faint and may lose consciousness
  • Caused by a drop in blood pressure and pulse that can lead to reduced blood flow to your brain.
  • Potentially triggered by nervousness about the donation process or your body’s natural reaction to the donation process & fluid loss
  • Symptoms include feeling lightheaded, dizzy, weak, cold sweat
  • Majority of the reactions fall under this category

Phlebotomy related: 

  • Any issue that is a result of the needle stick or vein puncture
  • Usually the result of infiltration, where the needle goes completely through the vein. 
  • Can result in a bruise or hematoma with some mild pain in the arm
Hematoma bruise plasma donation

Most of the time these reactions are pretty minor and easily managed.   It’s estimated that mild reactions occur in less than 2% of the donations.  A mild reaction will resolve on its own in under 15 minutes and not require intervention from the staff.    

How often do more severe reactions occur?

One of the primary focus areas of the plasma industry is donor health.  Plasma companies need to document any adverse reactions that donors experience.  The Plasma Protein Therapeutics Association (PPTA) is an organization that administers standards and programs to ensure the quality and safety of plasma. They performed a detailed study of donor reactions where they evaluated over 7.5 million donations.  

According to this study, the rate of moderate or severe reactions were rare at only 0.2% of donations.   That is only 20.9 reactions per 10,000 donations, with the vast majority falling on the moderate side. There were 2 categories that made up 93% of these reactions.

Moderate / Severe Vasovagal Reaction:  14.8 reactions per 10,000 donations 

  • Considered more serious if there are additional issues beyond the mild symptoms of lightheaded, dizzy, weakness
  • Moderate reactions occur when the donor also has nausea/vomiting or the reaction lasts over 15 minutes with staff intervention.  There can also be a brief loss of consciousness, under 1 minute. Moderate reactions comprised 94% of the reactions in this category.
  • Serious reactions occur where the donor has an extended loss of consciousness or additional symptoms like spasms/seizures, chest pain, loss of bladder/bowel control.  Injury can also occur if the donor faints while standing.   
  • These reactions are not pleasant to go through, but you should start to feel better once the episode stops.  It may take a few hours to fully recover depending on the severity of the event.

Moderate / Severe Phlebotomy related:  4.6 reactions per 10,000 donations

  • Considered more serious if the bruise or hematoma is larger than 2” x 2” or there is significant pain
  • Large bruises can result when an infiltration occurs during the process.  The blood is pumped back into the tissue surrounding the vein, instead of into the vein itself.  This represents 83% of these reactions. If you look online, you will usually find pictures of these reactions.  They tend to look a lot worse than they really are. Eventually, the blood will be absorbed back into the body, just like any other bruise.
  • Nerve irritation can occur when the needle insertion hits a nerve.  This can cause intense pain or arm numbness/tingling.
  • Other rare issues can be an infection, arterial puncture, or vein damage
large hematoma bruise plasma donation

Other:  1.5 reactions per 10,000 donations

  • Primarily comprised of moderate reactions to Citrate.  This is an anti-coagulant used to prevent the blood from clotting during the process. 
  • Symptoms include a metallic taste and numbness/tingling in the lips, toes, or fingers. 

Based on this study, severe reactions were very rare.  They only occurred at a rate of 2 per 10,000 donations or 0.02%.  To put that in perspective, as a donor you can donate a max of 104 times a year.  For an individual to get to 10,000 donations, they would need to max out donations for 96 straight years.       

Am I at a higher risk for side effects?

There were 4 groups that showed a higher probability to have moderate to severe reactions:

First-time donors

  • One of the largest differences is between first-time donors and repeat donors.  The odds a brand new donor will have a reaction is over 6 times that of a repeat donor.  This is not surprising given new donors do not know what to expect and may not be as prepared.  Also, once they have a bad experience, they are less likely to return. 
  • If you do experience side effects your first time, it may take a few donations for your body to get used to the process.  You might want to try again if it was manageable. For your plasma to be used to create therapies, you will need to donate 2 times.  Also, the reaction rates start to go down as you donate more so it may be better the next time. 

Younger donors (18 – 20)

  • Donors who are age 18-20 are 2-4 times more likely to have a reaction depending on the age group.  The rates decline as the age groups get older and donors in the 45-64 age group had the lowest rate.

Lower weight donors (110 – 124 pounds)

  • Donors who weigh between 110-124 pounds had the highest incident rate.  The rates decline as the donor weight increases. This likely has to do with the fact that the plasma removed is a higher percentage of their total plasma. It is in the range of the FDA requirements, but some people just don’t react well.  

Female donors

  • Overall females are around 3 times more likely to have a reaction vs a male.  Some of this can be tied to the weight impact highlighted above as women tend to be lighter.  

The intent in providing this information is not to scare certain people from donating.  It’s about helping you understand what you could expect. If you do fall into one of these groups, you need to be better prepared.  Although it isn’t a guarantee things will go smooth, you will want to do all you can to avoid having a complication. Refer to this article where I highlight what you can do to prepare for plasma donation.

However, the probabilities of any of these groups having a reaction are still pretty low.  One of the groups most likely to experience moderate/severe side effects is a female, first-time donor, but even that is only at 1.3%.   The key is once you get past that first donation, things should be easier from that point on.

Is it safe to donate plasma

When I talk to donors about this, there are really 3 different things they want to know.

1. Is the process safe

As I mentioned earlier, donor safety is one of the highest priorities for plasma companies. 

The modern plasma donation process (plasmapheresis) has been around since the 1960s.  There are over 50 million plasma donations a year and it is a highly regulated industry.  Centers must be licensed by the FDA and are subject to regular audits to check for compliance.

plasma donation safe FDA

The US is the source of the majority of the world’s plasma supply.  In order for US plasma to be used around the world, agencies from Europe and Asia will also perform audits of the US centers to ensure compliance with their specific regulations.  

2. Is it safe for my body

It’s understandable that you might be concerned with the dangers of donating plasma.  It does involve blood leaving your body then being returned. Your blood will always be safe.  All materials that come in contact with blood are single-use and sterile. A new, fresh set will be used for every donation.

Plasma is critical to your health, which is why it is in demand to make therapies.  But you can donate a portion as your body will naturally regenerate it within 24-48 hours. Before every donation, there will be tests to see if your protein levels are in a safe range.  If it is too low, you will not be allowed to donate as your body may not have enough key proteins to spare. 

You will only donate the amount of plasma that is safe based on your body weight.  There are also strict FDA guidelines on how frequently someone can donate. These limits are set to allow your body to replenish the lost plasma before you can donate again.

3. Is the plasma location safe

There is a negative perception about plasma donation from people who don’t know much about it. If you have never been to a plasma center you may assume only homeless, drug addicts, and sketchy people donate plasma.  I’ll admit that I thought the same thing. 

As I got involved in the plasma industry, I realized I couldn’t be more wrong.  In reality, plasma donors come from all walks of life and more than likely are not too different from you.  There is no “type” who donates. The people at a plasma center will be just like the ones at your neighborhood Target, Wal-Mart or Dollar General.  Yes, there will be some that look like they should not be there, but that’s not the norm.

There are a number of steps in place to make sure only qualified donors can participate.  Of course, people will lie when it comes to getting money, but there are checks and tests that will weed them out. 

  • You will need to prove you have a permanent address. Companies keep a list of addresses around the center that do not qualify as a permanent address, like half-way houses, motels, shelters, and other types of short-term housing.  Student housing is not considered short term housing and is acceptable.
  • You need to take a physical exam with a licensed medical professional before your first donation.  They’re trained to look for signs of drug use & addiction as a part of that process. 
  • The donor’s vitals are checked before each donation to ensure they are in a healthy state.
  • There is a shared industry registry of donors who are ineligible to donate plasma.  If you get permanently rejected at one center that will prevent you from donating at any other center in the US, across all companies.  

Plasma centers are located in many different types of areas.  Some are in rougher areas where you may not feel comfortable.  If this is a concern of yours, here are a few things you can do. This list comes from conversations with many donors who have felt the same thing.  

  • During the daytime, drive by the center first to get a feel for the neighborhood
  • Park outside for 10-15 minutes to get a sense for who is coming and going
  • Bring a friend with you the first time or go with someone who is already a donor (added benefit, there may be a referral bonus available)
  • If you do decide to donate, make sure you have 3-4 hours before it gets dark as your first visit will be longer due to the extra steps and wait time.  You want to make sure it is still daylight when you leave.

As I stated earlier, plasma donors are just like everyone else, but this is a personal decision for you to make so you will need to be comfortable with both the process and the location you donate at.  If you have the option of multiple centers around you, you may want to check each of them out as not all centers are the same.  

Long term effects of donating plasma

Plasma donations have been going on for over 50 years.  Over that time, there have been hundreds of millions of individual donations.  

There’s a consistent debate around the long term impacts of plasma donation.  No matter the issue there will always be people on both sides, like how there is a surprisingly large group of people who still think the Earth is flat.  However, many studies have shown plasma donation to be safe. There is always room for more information so studies and tests are being run on a consistent basis.

Here are some examples of research conducted on plasma donation or plasmapheresis. 

plasma donation research

A prospective multicentre study on the safety of long-term intensive plasmapheresis in donors (SIPLA)

Conclusion: Long-term intensive donor plasmapheresis under conditions investigated in this study is safe. All donors weighing > or = 70 kg are safely able to donate 850 ml of plasma in each session up to 60 times per year, provided that they are carefully monitored.

Safety and Long-term Effects of Plasmapheresis 

Conclusion: No consistent clinical or laboratory value abnormalities were found during more than six years of plasmapheresis of donors who gave as much as the plasma equivalent of four units of whole blood per week. Potential hazards to the plasmapheresis donor, including hemoglobin depletion, protein depletion, iron depletion, and misidentification of blood returned to the donor are discussed. In addition to affording an economic and efficient opportunity to expand component therapy, repeated plasmapheresis of a small pool of preselected donors can provide a better quality product than that obtained from random donors. 

A prospective trial on the safety of long-term intensive plasmapheresis in donors.

Conclusion: The reasons why donors cease to participate in intensive plasmapheresis programmes are predominantly not directly related to the plasma donation itself.

On an individual basis, there could be some long term impacts if you had a severe reaction.  These will be very rare, but there is a possibility.  

I have also seen some scarring on the arm from the needle punctures for consistent long-term donors.  This is more of a visual side effect as there isn’t any pain or other issues associated with the scar.  Sometimes this may go away, but there could be a noticeable scar that may cause some questions.   

Does donating plasma hurt

Anything that involves a needle going into your arm will hurt to some degree.  It is pretty minor and unless you are afraid of needles/blood, it should not be an issue.  I have a follow-up article on this here.

What’s the bottom line, is it safe for me to donate plasma

This is the most frequent question I hear from people about plasma donation. There is no easy answer to this as everyone is different. My goal is to provide as much information as possible so you can make the best decision for your specific situation.  Let me know if there is anything else on your mind by leaving a comment.  

This is part of a series of articles I have on donating plasma.  Other topics include: