Hematology: Crackdown on Plasma

Plasma is a has-been—or should be. Yet each year an estimated 100,000 Americans receive transfusions of plasma, which is the almost colorless liquid portion of whole blood that has been collected from many donors and pooled. Used after burns, wounds or hemorrhage, it is credited with having saved the lives of countless accident victims and battle casualties. All too often, however, pooled plasma carries hepatitis virus, and its assorted proteins may cause severe allergic-type reactions. Last week the Division of Biologies Standards, the Federal Government's watchdog over all medicinal preparations containing blood fractions, took legal steps to halt shipment of plasma in interstate commerce, and thus drastically curtail its use.

The reason some doctors continue using the liquid is the widespread belief that it can be made safe by subjecting it to ultraviolet radiation and storing it for six months at 86°-90° F. Many physicians also believe that plasma substitutes are in short supply. Neither assumption is true, say the American Red Cross and the Greater New York Community Blood Council. Salt solutions and synthetics such as dextran are plentifully available. So is serum albumin; although extracted from plasma, this can be filtered and heated sufficiently to make it noninfectious.

Much of the opposition to the elimination of plasma comes from the scores of blood banks that make a profit out of plasma. They can extract it economically from outdated whole blood, which cannot be used after storage for 21 days, keep it indefinitely and ship it easily. Most of them lack facilities for extracting serum albumin, and would have to buy that. But if they do not ship across state lines, federal regulations cannot touch them. Meanwhile, the number of federally reported cases of serum hepatitis—a miserably lingering and debilitating liver disease, sometimes fatal—is running at double the 1967 rate, with 2,050 cases tallied so far this year.