Plasma donation rule change for athletes

  • Integrity Blog

Did you know the 2024 Prohibited List permits the donation of plasma via plasmapheresis, providing it is performed in an official registered collection centre?

The World Anti-Doping Agency (WADA) made this key change to allow athletes to donate plasma for humanitarian or other personal reasons. The change came into effect from 1 January 2024.

Sport Integrity Australia’s Medical Advisor Dr Laura Lallenec explains what plasma is, the function it plays in the body and the effects athletes may experience if they choose to donate their plasma.

Plasma donation entails blood products being removed and then reintroduced back into the circulatory system.

“Plasma is the liquid component of our blood and makes up 55% of our blood volume,” Dr Lallenec says.

“Plasma transports cells, proteins, hormones etc. around the body and removes waste. It helps to transport proteins that provide our immunity and electrolytes that regulate the blood’s chemistry. Plasma is mostly water (around 92%) and helps to maintain our circulation.”

Nurse showing donor their collected plasma during donation procedure

She says plasma is used for treating various medical conditions such as autoimmune disease, burns, organ transplantation, liver failure, trauma, infections and bleeding disorders. It is also used to prepare immunisations such as the Tetanus vaccine.

Plasma donation

“Plasma donation involves a plasmapheresis machine which draws blood from your arm via a needle,” Dr Lallenec says.

“The machine then separates the blood into red cells and the plasma component. The red cells are returned to you during the donation. A small amount of anticoagulant is added to stop the blood clumping together (clotting) in the machine. This process is repeated a number of times until the desired amount of plasma is obtained, based on your weight and height.”

Plasma donation requires approximately 45 to 90 minutes. The volume of plasma draw is approximately 800mls. Common side effects include bruising at the site of the donation, feeling faint or lightheaded.

The day before you donate, you should hydrate well with approximately 2000-2500mLs of water or other fluids. You should have a good night’s sleep and avoid foods that are high in fat.

Dr Lallenec advises that “in the three hours before you donate, you will need to drink 750mL of fluids and avoid strenuous exercise”.

“It is advised that the donor rests for a minimum of three hours after the donation and to be off your feet to allow recovery.

“You should avoid strenuous exercise and overheating for 24 hours after your donation. Plasma donation may have a temporary impact on performance if you are an elite athlete undertaking high intensity exercise.”1.

Is a Therapeutic Use Exemption needed?

A Therapeutic Use Exemption (TUE) is not required if athletes wish to donate plasma (or whole blood donation) however you should ensure that a detailed medical record from the blood bank is kept which confirms the date, type and volume of the donation.

This is particularly important if the athlete is in a Registered Testing Pool and if testing involves the Athlete Biological Passport (ABP).

This is because evidence of plasma loss (whether intentional as part of a doping regimen or through an accident, illness or blood donation) may result in changes to an ABP and you may be asked to explain these changes to anti-doping authorities. A record of donation would assist in these circumstances.

Plasma infusion is still prohibited

While plasma donation is now permitted, plasma infusion (i.e. receiving plasma) remains a Prohibited Method. This treatment is usually required in serious medical conditions, and athletes should undergo required medical treatment and apply for a TUE after their condition has stabilised. If you receive an infusion for any reason, you should read Athlete Warning: IV Infusions as it may be prohibited in certain circumstances.

References:

  1. Effect of plasma donation and blood donation on aerobic and anaerobic responses in exhaustive, severe-intensity exercise - PubMed

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