Alpha-1 antitrypsin is a protein found in blood plasma. When an individual has severely deficient levels of the alpha-1 protein in their blood, it can cause emphysema. For these individuals, medical providers recommend augmentation therapy to replace what their bodies do not make naturally. Healthy plasma donors make this possible by donating their plasma. The goal is to raise the circulating alpha-1 protein in the lungs to a protective level that will slow the progression of lung destruction and, thus, improve quality of life.
Donating blood through organizations such as the American Red Cross is a noble cause that saves lives. These organizations supply most of the blood and plasma used in hospitals and emergency disaster situations. Donating plasma for alpha-1 antitrypsin deficiency-related augmentation therapy, however, is more complex and requires a unique production process. Therefore, most of the manufacturers of augmentation therapy medications have their own plasma collection centers. In the US, Grifols manufactures Prolastin-C and owns Biomat. CSL Behring manufactures Zemaira and owns CSL Plasma. Takeda manufactures Aralast and Glassia and owns BioLife Plasma.
To understand this process, it’s important to note that treating just one Alpha-1 patient for a year requires 900 plasma donations. Plasma contains hundreds of essential proteins and antibodies, and these proteins cannot yet be synthetically replicated. This creates an ongoing need for committed donors to help manufacture these treatments.
Donor candidates must first qualify through a unique screening process that is exclusive to each company. To qualify, each person must pass a physical exam and comprehensive health screening at a donation center.
Plasma is collected from qualified donors using a process called plasmapheresis which separates the plasma from the red and white blood cells, collects it in a bottle, and returns the other parts of the blood back to the donor. Safeguards are implemented when alpha-1 antitrypsin is extracted from the plasma of qualified donors. Plasma centers routinely test a potential donor for HIV/AIDS, hepatitis, and other infectious agents, then take the plasma donations and freeze them. Two to six months later, they retest the donor for the various infectious agents. If all the testing is negative, they release the plasma that was collected 2-6 months before. If the donor doesn’t return for the repeat testing, the plasma is discarded. Once a donation is cleared, the Alpha-1 is purified and bottled into a usable form, alpha1-proteinase inhibitor, ready for alpha-1 antitrypsin deficient patients to infuse.
Unlike many blood donation centers, these plasma centers pay their qualified donors. Each center pays different amounts. Since they are collecting plasma and returning red blood cells and white blood cells from the whole blood, donors can give more often, up to twice a week, with 48 hours between donations.
Alpha-1 patients should encourage their healthy family members and friends to seek out these specific donation centers and donate plasma as a way of supporting those with Alpha-1 Antitrypsin Deficiency.