80% of plasma banks confined to just 4 districts

A total 31 of 39 approved blood collection centres are in Ahmedabad, Vadodara, Surat and Rajkot, while the remaining eight are in six other districts; of these, only 26 have the facility for apheresis, wherein blood is returned to donor’s body after separating plasma

Convalescent plasma transfusion therapy has shown promise in treatment of Covid-19, if administered on time, say health experts. Following initial clinical trials, the Indian Council of Medical Research (ICMR) allowed off-label use of this therapy in the State. Subsequently, in June, 39 blood banks of Gujarat were authorised to collect plasma from patients who have recovered from the infection. However, 31 (or nearly 80%) of these 39 centres are concentrated in just four districts of Gujarat.

Ahmedabad has the maximum convalescent plasma collection centres, 12, while there are eight in Vadodara, seven in Surat and four in Rajkot—31 in just four districts. There are two each in Bhavnagar and Jamnagar and one each in Anand, Gandhinagar, Patan and Valsad.

Again, only 26 of the 39 have the facility for apheresis, a procedure wherein individual components can be separated from the blood and the remaining blood can be reintroduced into the donor’s body. This method allows collection of two units of blood at a time. The remaining 13 centres do not have the facility. Hence, they can collect only one unit per donor.

The 26 centres, a mix of private and public institutions, are located in nine districts, said officials of the Gujarat chapter of the Indian Society for Blood Transfusion and Immunohematology (ISBTI-Guj).

Speaking about the distribution of plasma banks, Dr Nidhi Bhatnagar, chairperson of ISBTIGujarat, said, “Major plasma banks are located in large cities because they have seen major spurt of Covid-19 cases as well as because of infrastructure. Many hospitals and patients seek plasma from the banks in these four major cities and it is given to them. However, demand is less in smaller cities because off-label use is dependent on clinicians and whether they decide to use it on their patients.” Dr Rajesh Gopal, president of Gujarat State Council for Blood Transfusion (GSCBT) was unavailable for comments.

Why plasma donation is important


On importance of plasma therapy, Dr Tushar Patel, critical intensivist and member of the State Covid Task Force, said, “Those suffering from Covid do not have antibodies. If they are given ready antibod ies in the form of plasma from recovered patients, there is lesser organ damage due to neutralising effect on the SARS-CoV-2 virus. It also reduces stress on the patient’s body attempting to fight the virus.”

He added, “It is true that plasma has had questionable results but the main problem here appears to be the level of antibodies, inadequate knowledge of plasma usage and timing of plasma being administered to patients. Plasma needs to be administered between 7-10 days of infection when the patient has hypoxia but hasn’t had development of cytokine storm. This would give better results.”

On lack of plasma use in peripheral districts of Gujarat and unavailability of plasma banks therein, he said, “Apart from the lack of infrastructure, it is also the lack of adequate antibody testing mechanism and a certain reluctance among smaller blood banks and doctors to accept the method.”

Highest plasma donation and distribution at SMIMER Sardar Vallabhbhai Patel (SVP) Hospital in Ahmedabad became the first centre in India to be approved for Convalescent Plasma Clinical Trial for Covid-19 patients. While Ahmedabad Municipal Corporation (AMC) announced the creation of the first such convalescent plasma bank in Gujarat, it was SMIMER Hospital in Surat that has received the maximum donations and also distributed the highest number of units so far.

Data from the GSCBT show that SMIMER Hospital in Surat has received 610 plasma donations and already distributed 876 units till September 15. This is the highest in the state so far and double than that at the next leading blood bank in Gujarat. Six of the 26 centres currently account for 65% (1,791) of all plasma donations made in Gujarat. They also account for 72% (3,012) of all plasma units used in treatment of Covid-19 patients in the state. As per data from across the state, a total of 2,741persons have donated blood at the 26 blood banks in the state so far. So far, these centres have distributed 4,195 units of plasma to patients.

Dr Ankita Patel, HOD of IHBT at SMIMER said, “Initially, we faced a lot of problems and had just 1% turnout. However, later the message spread through word-ofmouth. We also got help from the diamond sector. We have had more than 150 donations just from diamond workers. The police, doctors and others too came forward to donate plasma. Today, we don’t have to refuse anyone for plasma.”

The next highest collection was by the Indian Red Cross Society (IRCS) Blood Bank in Ahmedabad which got 312 donors and has given out 624 plasma units so far. The number of plasma units given out is more than the number of donations collected because two units of plasma can be given for each donation made through apheresis. Covid patients need two such units during the course of treatment.