The Story: Bill and Jake’s Plasma Journey
It is a story of two friends who are having an intellectual and entertaining discussion about plasma donation.
Bill and Jake arrived at the blood bank an hour before the operation. They have been friends since high school, and only parted ways during college. Jake took two courses (Psychology & Biology) in Pennsylvania, while Bill went to New York to finish a degree in Marketing Management.
Jake: I didn’t expect you here.
Bill: Me too. What brings you here?
Jake: I’m making a difference and saving lives.
Bill: I’ll meet my group tonight to finish a project, so I’ve decided to come here and observe.
Jake: Just observe? Oh come on.
Bill: Of course mate! I’ll also donate plasma— my first time to do it.
Jake: Don’t worry, everything’s gonna to be fine. I already donated my plasma five times and here I am, still alive and kicking.
Bill: I see that.
Jake: Yeah. And you know what? This campaign is kinda cool. The money helps me survive college.
Bill: Cool! So how much do you regularly receive?
Jake: Thirty dollars… sometimes higher. It basically depends on how many pints you want to donate and how often you donate. I heard there are some banks who are willing to pay as high as $150 for first timers.
Bill: Sounds good! But I’m curious— what’s plasma? I’m aware that this is one of the popular industries in the world, but I don’t understand what’s really in it.
Jake: Plasma is basically a component of blood. The human blood is composed of red blood cells, white blood cells and other chemical substances. One of those chemical substances is protein and it’s called plasma.
Bill: Yeah, I kinda remembered that term in my biology class. Is that the yellow liquid?
Bill: I also remember that the plasma constitutes 55% of the total blood volume. In fact, 93% of plasma volume is water and its density is 1.025 kg/l.
Jake: That’s right. Plasma also contains dissolved substances such as glucose, mineral ions, hormones and carbon dioxide. These substances are transported around, protecting the human body from diseases. You know what? It’s awesome to hear that you also pay attention to your textbook.
Bill: Well, I got a final grade of 90 in Biology.
Bill: Here’s the funny part: our final exam is about body systems and I got no answers in the enumeration part.
Jake: What’s the question?
Bill: What are the benefits and uses of plasma?
Jake: Plasma has numerous benefits and uses. First, it acts as an immunoglobulin to treat immunological disorders. Second, it’s used in biotherapies to cure bleeding disorders, severe burns, wounds and sepsis.
Bill: Can you give me examples of bleeding disorders?
Jake: Hemophilia and von Willebrand disease.
Bill: I’m quite familiar with those.
Jake: Not only that— plasma is also used to cure a genetic disease that’s called alpha-antitrypsin deficiency.
Bill: Is that the disease that can lead to liver and lung failure?
Bill: If that’s the case, plasma is also useful in surgeries?
Jake: Yes, especially cardiac surgeries.
Bill: What else?
Jake: Plasma has an important role in fluid replacement therapy.
Bill: What’s that?
Jake: It is a type of medical practice that refills your body with bodily fluids, administered either by oral intake or intravenous.
Bill: I’ll keep that in mind. It’s cool that we are having this conversation and I get to realize the importance of plasma.
Jake: Plasma is important, that’s why we’re here to donate.
Bill: Yeah. I’m a hero now.
Jake: We are!
Bill: How about a brief history about plasma donation? Are you aware of that?
Jake: Yes. I made a research about the topic last night.
Bill: Just the right question at the right time, mate.
Jake: Plasma donation began in World War II. That time, they used “dried plasma.” They just mixed it with water and administered it to patients. In 1940, Dr. Charles Drew headed a campaign, and the primary goal was to gather blood in New York City Hospitals to ship the plasma component in Great Britain.
Bill: What’s the name of that campaign?
Jake: Plasma for Britain.
Bill: Is it successful?
Jake: Yes. The campaign produced a number of dried plasma packages for the army and navy. The package made use of two tin cans consisting of 400 cc bottles and distilled water.
Bill: That way, the dried plasma could easily be used and would stay fresh. But for how long?
Jake: Four hours.
Bill: Nice. What happened to Dr. Drew then?
Jake: Dr. Drew became the director of Red Cross and the assistant director of National Research Council. He was the one who argued that there was no racial difference in blood donation. To him, this policy would only lead to unnecessary deaths of soldiers and sailors. The American Red Cross even donated six million packages of plasma by the time the war ended.
Bill: Is there any excess?
Jake: Yes, there is. The excess plasma was returned to our country for the civilians.
Bill: So if dried plasma was very popular during the war, how come it’s not practiced today?
Jake: Because of plasmapheresis.
Bill: What’s that?
Jake: Plasmapheresis uses a modern machine to separate the whole blood from plasma. It was in 1959, when Michael Rubinstein became the first person to use this procedure. His mission was to save a teenage boy with blood disorder.
Bill: Was the procedure successful?
Bill: Tell me more about plasmapheresis.
Jake: There are three types of procedures to separate plasma from the whole blood. First is discontinuous flow centrifugation. This procedure only requires the use of one venous catheter line, and about 300 ml of blood is removed at a time. The second is continuous flow centrifugation.
Bill: Let me guess. There are two venous lines used in that?
Jake: That’s right. This method only requires less blood volume at a time.
Bill: What’s the third type?
Jake: The third type is plasma filtration. It also makes use of two venous lines and a hemodialysis machine. This procedure removes about 100 ml of blood from the human body at a time.
Bill: If that’s the case, what will happen to the other components?
Jake: After the plasma is separated, the other components will be returned to the donor.
Bill: Are you saying that plasmapheresis is a longer process than the traditional blood donation?
Jake: Yes. The entire process of plasmapheresis can take up to one hour. Sometimes, it can take two, three or even five hours for first time donors.
Bill: That’s certainly a long wait.
Jake: Yeah, but the wait is all worth your effort. You can read a book or watch TV while waiting. During my first visit here, three hours just flew by and I wasn’t bored at all.
Bill: What did you do?
Jake: I read my physiological-psychology book.
Bill: You didn’t only donate blood and become hero that day, you also learned something valuable.
Jake: That’s right.
Bill: So cool! Even cooler that they allowed you to donate.
Jake: Yes. I am an eligible donor.
Bill: What are the qualifications?
Jake: The first consideration is your age. Plasma donors must be at least 18 years of age until 65. There are some centers which allow 17-year old donors, but they’re required to present a written consent from their parents. The consent must also be approved by a qualified physician.
Bill: The weight should also be a consideration, right?
Jake: Yes. Your weight— and also your height— determine the amount of plasma you’re allowed to donate. The ideal weight of a plasma donor must be at least 110 pounds, with a healthy level of fat.
Bill: Are you saying you can’t donate if you’re too skinny or too fat?
Jake: Not always. Before you become a donor, you still need to pass a series of physical examination. Your blood will be tested for hemoglobin levels and diseases like HIV, hepatitis, anemia, bone marrow problems, etc.
Bill: In other words, the licensed medical physician conducts a thorough medical history, and a questionnaire is given to you and you should answer it truthfully.
Jake: Yes, the one reason why banks have less donors.
Bill: How come?
Jake: Some people are too hesitant to answer personal questions. Some even conceal their past experiences and, as a result, they only fail.
Bill: I agree. The pre-screening questionnaire is strictly supported by medical procedures, therefore, there’s no room for liars.
Jake: Right. It’s also difficult to lie about your citizenship. Banks require you to submit valid documents, identifications and proof of residency. In Canada, banks already ban donors from UK, France and Saudi Arabia due to the alarming spread of a brain-wasting disease.
Bill: I’ve read that news a month ago. That brain disease is called Creuzfeldt-Jacob Disease, right?
Jake: That’s right!
Bill: How about those people with tattoo or piercing?
Jake: They’re still qualified— only if they got the tattoo or piercing within the last twelve months. Even those people who are addicted to booze are not allowed.
Bill: I have no problem with that. I only drink during special occasions.
Jake: Have you had a drink last night?
Bill: No. After eating my dinner, I just watched an episode of Survivor and hit the sack right away.
Jake: That’s good, mate. You’re all prepared for today.
Bill: I am. But before going here, someone told me that donating plasma can be really painful. It also has side effects.
Jake: Plasma donation isn’t painful at all. Yes, you can feel a pinch of pain upon the insertion of the needle. In case the pain remains, you can immediately inform the staff.
Bill: How about the side effects?
Jake: Side effects are inevitable, especially if you’re a first timer. But these effects are only minimal. A little dizziness can usually be experienced after the procedure, but if you’ll rest and relax, you’ll be okay. The probability of having serious side effects is low and it can only happen if you regularly donate plasma.
Bill: So, donating plasma regularly is not advisable?
Jake: That’s right. Frequent plasma donation can lead to soreness, skin discoloration, skin rash, unexpected seizures, trouble in breathing, abdominal pain, vomiting and nerve damage.
Bill: It’s also said that donating plasma is risky. It’s a way of making a difference, but you also put your health at risk.
Jake: Yes, especially when you are only abusing the payment system. It’s not right to donate plasma only for the money. Your number one goal should be to help people who are in need.
Bill: I agree. No matter what your reason for donating is, plasma donation is still a humanitarian work. To me, there’s nothing wrong with the compensation that the donors receive. This strategy is just a simple gift.
Jake: Right on, mate. Money also motivates people, and what could be more awesome than banks giving you money in exchange for saving three or more lives per pint of plasma, right?
Bill: Yeah. I’m also curious to know what other advantages or benefits donors can receive apart from the money.
Jake: Free consultation. Your system will also be replenished by new plasma.
Bill: That way, you’ll be healthier, right?
Bill: I guess there are also disadvantages in donating plasma?
Jake: We already talked about the side effects.
Bill: Yeah, I don’t mean health disadvantages but bent more on the social impact.
Jake: There is. We discussed that in our sociology class.
Bill: What’s that?
Jake: Ever heard of the Leon Anderson study in Ohio University?
Jake: Anderson is a sociologist. He conducted a study in 1999, and the findings shocked him.
Bill: He found out paid donors are alcoholic and smokers?
Jake: Smart guess. How did you know?
Bill: Just my analysis.
Jake: Worst part is these college students came from families who have an income of $50,000. Anderson also discovered that more donors drink liquor and smoke tobacco five times a week.
Bill: That’s very bad!
Jake: Five times or, to some of them, it’s more than five. Can you just imagine how damaging that is to their health?
Bill: They’re killing themselves.
Jake: Precisely. Anderson’s study was only conducted in a school. There were only 411 participants and the age bracket is between 18 to 22 years old. How much more if we’re going to run a study with two million donors worldwide?
Bill: One thing’s for sure.
Jake: What’s that?
Bill: The two of us are not part of that group who screw their lives.
Jake: Kudos to what you said!
Bill: Do you think there are still solutions to this problem?
Jake: I’m sure there are. These group need to realize how wrong their behaviors are. The fact that they’re still in their young adults; they just need proper guidance… and even counseling. As for Anderson, he recommended a two-way agreement between profit/non-profit plasma banks and the Food Drug Administration (FDA). They need to guarantee the quality of blood is still high, while the overall health of donors are not put in peril.
Bill: I agree. Perhaps more TV commercials and radio ads on proper health care are needed. The plasma regulation process also has an important role and it mustn’t be too lenient. Are you aware of the plasma regulation process? I get a bit confused if it’s truly effective or not.
Jake: Just like I said, every blood plasma regulation is expected to start with a donor screening. Donors basically go through two medical exams and a complete medical history. After donation, the plasma is examined for infectious viruses. The plasma that came from non-eligible donors are put on the prevented list. All plasma products are stored and quarantined until obligatory tests are conducted.
Bill: What’s the bottomline?
Jake: The most important thing here is: all donation establishments must stick to the safeguards and report gaps to the FDA.
Bill: Do these donation banks enroll in international institutions to preserve the quality of the plasma?
Jake: Yes. That’s also an important plan of action. These banks should choose to enroll in the International Quality Plasma Program. The IQPP will provide you extra standards and supervision.
Bill: How about the medical therapies or biotherapies? Are these things well taken care of?
Jake: Of course. These plasma-manufacturing process used in medical therapies are under the watch of Plasma Protein Therapeutics Association (PPTA).
Bill: That’s great. We must see to it that everything we do here will never get wasted.
Jake: Of course. All our donations are in good hands.
Bill: In any instance, can you contact these institutions to help find the best blood bank in town?
Jake: That’s possible. But if I were you, I’ll go straight to the search of plasma banks.
Bill: Is there any online directories to help me with that?
Jake: Yes. There are a lot of them and I usually use Bloodbanker. The site allows you to search for the best blood bank near you. You can locate them by state, by name of the company, and by zip code.
Bill: Thanks for the suggestion. I’ve never tried that one. This morning, I only used my phonebook.
Jake: Yeah, that’s possible too. Yet, using the Internet is two times faster and you don’t need to phone them. You can directly visit their website for more information.
Bill: I agree with that.
Jake: Mate, you told me earlier that you’ll be finishing a project.
Bill: Yeah, that’s tonight. What time is it?
Jake: We still need to wait thirty minutes before the operation starts. What’s that project all about?
Bill: Market shares of multi-billion industries in the world.
Jake: There could be a lot of them.
Bill: Right. Twenty hours are not enough to search for them. Did I tell you these blood banks are among the multi-billion industries?
Jake: Yeah, I remember. Can you expand on that topic?
Bill: Two days ago, I discovered that there are a total of 363 certified plasma centers in our country, in Europe and in Canada. Four years ago, about 1.1 million plasma donations were made.
Jake: That’s a lot. What are these giant industries then?
Bill: We are sitting in front of it – the BioLife.
Jake: And are you aware of other companies which have the biggest market share?
Bill: Wait. Let me take a look at my notes. I want to be accurate with the numbers.
Jake: Awesome. Let me hear everything you know.
Bill: The first company on my list is CSL Behring. The company is one of the global leaders in plasma production. They have more than 9,000 employees in 19 countries.
Jake: How did they get the name Behring? Is that their founder?
Bill: Yes. CSL gives high credit for all the scientific contributions made by Emil von Behring. Behring came up with the serum therapy, and it won Nobel Prize in 1901.
Jake: What’s their connection with CSL Plasma?
Bill: They also run it. CSL Plasma is the source member, and it has networks here and in Germany.
Jake: How about their sales? Did you find any?
Bill: Yeah. Take a look at their website and you’ll know that the production cost of their plasma-derived therapies covers 70% of the selling price. I have no sale data on the current year, but I got the 2008-2009 figure. Are you interested in that?
Bill: CSL Behring had an income of roughly $2.78 billion in US dollars.
Jake: Not bad at all!
Bill: Next on my list is the Kedrion. Just like CSL, the biopharmaceutical company, its headquarters is located in Italy and abroad. They also produce plasma products. In 2009, the company ended with a total net sales of 239.5 million euros.
Jake: If we’ll convert that in US dollars, that would be…?
Bill: It’s 345.6 million US dollars. In fact, their net sales increased by 43.4% in European Union alone and by 32.6% in the rest of the world.
Jake: Are you also familiar with Talecris Biotherapeutics?
Bill: Yes. Where have you heard that?
Jake: I just heard it from my dad.
Bill: Is he working there?
Jake: Not exactly. He just attended a seminar and many of the participants are from Talecris. He highly applauded all the employees for their passion and dedication to their work.
Bill: Nice to hear that. That’s probably one of the reasons why Talecris is acknowledged as one of the fastest-growing private companies. The Triangle Business Journal granted them an award for “Fast 50” in 2006, 2008 and 2009.
Jake: Cool! I might consider applying for a job there.
Bill: It’s not bad to include your name in over 4700 employees worldwide.
Jake: How’s their sales?
Bill: Talecris produced an 11.6% increase in revenue in 2009. That year alone, they exceeded the mark of $1.5 billion. Did I tell you they have a merger agreement?
Jake: No. With whom?
Bill: With Grifols. The Grifols-Talecris $4.5 billion deal will be extended until June 30, 2011.
Jake: Sounds like a good partnership to me. But what’s with Grifols? Who are they?
Bill: Grifols started in 1940 and it’s basically a group of companies which provides quality service to healthcare professionals and patients in more than 90 countries. Their primary objective is to research, develop, manufacture and market plasma products. Last night, I did my research and downloaded their 2010 annual report.
Jake: What did it say?
Bill: Grifols ended the year 2010 with a total revenue of 990.7 million euros or 1.43 billion in US dollars. There’s an increase of 8.5% compared to 2009.
Jake: Is there any source members of Grifols apart from their merger agreement with Talecris?
Bill: Yes, they have. I’m only aware of two companies, and these are Biomat USA and Plasma Inc.
Jake: Sounds familiar to me. What confuses me now is the difference between Grifols and its source members?
Bill: Good question. Grifols is at the top of the organizational chart. It’s the head and developer of a product. Biomat and PlasmaCare act as the providers. These two companies make sure that the supply of plasma is regularly adequate. Therefore, there’s always a two-way line between Grifols and its source members.
Jake: Yeah. Grifols can’t operate well without Biomat and PlasmaCare.
Bill: Right on the dot, mate.
Jake: How many plasma banks do these companies have?
Bill: One research claims that Grifols operates 70 banks here in our country – that’s in 2007. PlasmaCare’s main headquarters is in Cincinnati, Ohio. Biomat currently has 64 banks in 24 states and you can find all of them in their website.
Jake: Any more companies on your list?
Bill: Yes. We’ll now go to Bantex International Inc. Like the other global companies we discussed and with 47,600 employees worldwide, Baxter is a manufacturer, developer and marketer of plasma products. BioLife is, in fact, a part of the Bantex Healthcare Corporation.
Jake: That’s a very big company.
Bill: It is. Even in sales, Bantex stood out at $12.8 billion dollars. This big number includes plasma-based proteins products, medication delivery and renal treatments.
Jake: Mate, have you heard of Biotest? I thought it’s the biggest plasma industry.
Bill: Yes. Biotest is a popular pharmaceutical industry too, which gives more specialization in the application of haematology and immunology. As of the moment, the 2010 annual sales of the company clocks at $100 million.
Jake: Just to recap: in terms of sales, Biotest has $100 million (2010), CSL Behring has $2.78 billion (2008-2009), Kendrion with $345.6 million (2009), Talecris has $1.5 billion (2009), Bantex has $12.8 billion and Grifols with $1.43 billion (2010).
Bill: Out of the six global companies we mentioned, in years 2009 to 2010, it’s clear that Bantex leads the revenue race.
Jake: Having a revenue of $12.8 billion is nearly a work of genius. Where’s the main headquarters of Bantex, again?
Bill: The complete name is Bantex Bioscience and its corporate address is located in Deerfield, Illinois.
Jake: It would be interesting to have an apprenticeship in Bantex and get familiar with its entire operation.
Bill: Sound like a good plan to me. I’m sure you’ll be an asset in their corporation.
A bank volunteer in her early twenties came towards Jake and Bill. She’s wearing a white plan shirt and jeans. She appears to have a friendly personality, gave a smile at them and said:
Natalie: Hi, my name is Natalie Summers. I observed both of you arrived too early.
Jake: Yeah. Early bird catches worm as they say.
Bill: Do you work here?
Natalie: Not yet. I’m still a volunteer. By the way, the bank is now open. As the first donors, please sign your name here. (passing a sheet of paper)
Jake & Bill: No problem.
Natalie: Both of you are first-time donors?
Bill: I am.
Jake: It’s my fifth time here.
Natalie: Got it. For Mr. Bill Haynes, you should come with me for your physical examinations.
Bill: Where are we going?
Natalie: To meet Dr. Robert Moore. To Jake Howell, kindly proceed to our nurse for mandatory check-up.
Jake: Here we go, mate. You’re now a hero.
Bill: It’s just starting, mate. Fist pump to this!
As the three of them went inside the blood bank, three more donors arrived. Two of them were also first timers and joined Bill inside the examination booth. While Jake and Bill were still in the plasma donating room, the bank’s receiving area was filled with donors after thirty minutes.