Plasma

SUPERVISOR . Dr. bashar sahib

Preper by hanan khadim

‫حنان كاظم‬
Introduction

Plasma, also known as blood plasma, appears light-yellowish or straw-colored. It serves as the
liquid base for whole blood. Whole blood minus erythrocytes(RBCs), leukocytes(WBCs) and
thrombocytes(platelets) make up the plasma. Serum, sometimes mistakenly considered
synonymous with plasma, consists of plasma without fibrinogen. Plasma contains 91% to 92% of
water and 8% to 9% of solids. It mainly comprises:

1. Coagulants, mainly fibrinogen, aid in blood clotting,

2. Plasma proteins, such as albumin and globulin, that help maintain the colloidal osmotic
pressure at about 25 mmHg,
3. Electrolytes like sodium, potassium, bicarbonate, chloride, and calcium help maintain
blood pH.
4. Immunoglobulins help fight infection and various other small amounts of enzymes,
hormones, and vitamins.

Extraction of Plasma

It can be separated from whole blood by the process of centrifugation, i.e., spinning whole blood
with an anticoagulant in a centrifuge. Plasma is lighter, so it forms the upper yellowish layer,
while the denser blood cells fall to the bottom. Plasma forms 55% and red blood cells form 45%
of the total blood. The plasma collected is frozen within 24 hours to preserve the functionality of
the various clotting factors and immunoglobulins; it is thawed before use and has a shelf life of 1
year. Interestingly, while O- is the preferred universal donor for blood, the plasma of AB blood
groups are the most preferred because their plasma does not contain antibodies, making it
acceptable for everyone without fear of adverse reaction.

Plasma, like whole blood, is initially tested, to ensure the safety of recipients. As per the FDA
regulations, the collected plasma undergoes a battery of tests to identify transmittable diseases,
mainly hepatitis A, B, and C along with syphilis and HIV. The process of fractionation separates
individual plasma proteins
Plasma proteins

Plasma contains 6–8 percent proteins. One critical group is the coagulation proteins and their
inhibitors, synthesized primarily in the liver. When blood clotting is activated, fibrinogen
circulating in the blood is converted to fibrin, which in turn helps to form a stable blood clot at
the site of vascular disruption. Coagulation inhibitor proteins help to prevent abnormal
coagulation (hypercoagulability) and to resolve clots after they are formed. When plasma is
allowed to clot, fibrinogen converts to fibrin, trapping the cellular elements of blood. The
resulting liquid, devoid of cells and fibrinogen, is called serum. Biochemical testing of plasma
and serum is an important part of modern clinical diagnosis and treatment monitoring. High or
low concentrations of glucose in the plasma or serum help to confirm serious disorders such as
diabetes mellitus and hypoglycemia. Substances secreted into the plasma by cancers may
indicate an occult malignancy; for instance, an increased concentration of prostate-specific
antigen (PSA) in a middle-aged asymptomatic man may indicate undiagnosed prostate cancer.

Serum albumin, another protein synthesized by the liver, constitutes approximately 60 percent of
all of the plasma proteins. It is very important in maintaining osmotic pressure in the blood
vessels; it is also an important carrier protein for a number of substances, including hormones.
Other proteins called alpha and beta globulins transport lipids such as cholesterol as well as
steroid hormones, sugar, and iron.
Color

Plasma is normally yellow due to bilirubin, carotenoids, hemoglobin and transferrin.[11] In

abnormal cases, plasma can have varying shades of orange, green or brown. Green color can be
due to ceruloplasmin or sulfhemoglobin. Latter may form due to medicines that are able to form
sulfonamides once ingested (see sulfhemoglobinemia). Dark brown or reddish color can appear
due to hemolysis, in which methemoglobin is released from broken blood cells (see
methemoglobinemia). Plasma is normally relatively transparent, but sometimes it can be opaque.
Opaqueness is typically due to elevated content of lipids like cholesterol and triglycerides

Volume

Blood plasma volume may be expanded by or drained to extravascular fluid when there are
changes in Starling forces across capillary walls. For example, when blood pressure drops in
circulatory shock, Starling forces drive fluid into the interstitium, causing third spacing.

Standing still for a prolonged period will cause an increase in transcapillary hydrostatic pressure.
As a result, approximately 12% of blood plasma volume will cross into the extravascular
compartment. This causes an increase in hematocrit, serum total protein, blood viscosity and, as
a result of increased concentration of coagulation factors, it causes orthostatic
hypercoagulability
Plasma donation

Plasma as a blood product prepared from blood donations is used in blood transfusions, typically
as fresh frozen plasma (FFP) or Plasma Frozen within 24 hours after phlebotomy (PF24). When
donating whole blood or packed red blood cell (PRBC) transfusions, O- is the most desirable and
is considered a "universal donor," since it has neither A nor B antigens and can be safely
transfused to most recipients. Type AB+ is the "universal recipient" type for PRBC donations.
However, for plasma the situation is somewhat reversed. Blood donation centers will sometimes
collect only plasma from AB donors through apheresis, as their plasma does not contain the
antibodies that may cross react with recipient antigens. As such, AB is often considered the
"universal donor" for plasma. Special programs exist just to cater to the male AB plasma donor,
because of concerns about transfusion related acute lung injury (TRALI) and female donors who
may have higher leukocyte antibodies However, some studies show an increased risk of TRALI
despite increased leukocyte antibodies in women who have been pregnant

Related Testing

Water constitutes about two-thirds of the human body. In an adult man weighing 70 kg, the body
water content is about 42L. This water content is divided into two major compartments:

 Intracellular fluid (ICF): It forms about 28 L (about 40% of total body weight)
 Extracellular fluid (ECF): It forms about 14 L (about 20% of total body weight) of which
15% is interstitial fluid and 5% is plasma.

Plasma can be measured by the use of marker substances like radioactive iodine (131 I) and
Evans blue (T-1824). Evans blue is the commonly used marker substance aka tracer as it binds
strongly with albumin. The concept behind using a tracer is to use one that is well distributed in
the compartment of interest. A known amount of tracer is introduced into the compartment, and
its volume of distribution is measured.

Volume = Amount of tracer/Concentration of tracer

Compartment volumes are measured based on the volume of distribution of tracer. In the case of
measuring plasma volume, the albumin-bound tracer, i.e., Evans blue, is used. As albumin tends
to continuously leak out of the circulation, the tracer concentration is measured at serial intervals
and is plotted on a logarithmic curve. This curve is then extrapolated to identify a “zero time”
that allows the estimation of a virtual volume of distribution. The volume of distribution
measured is the volume of plasma

Function

As plasma forms the liquid base of blood, the functions carried out by plasma and blood overlap.
The multitude of functions include:

 Coagulation: Fibrinogen plays a major role in blood clotting along with other
procoagulants like thrombin and factor X.
 Defense: Immunoglobulins and antibodies in plasma play an important role in the body’s
defense against bacteria, virus, fungi, and parasites.
 Maintenance of Osmotic Pressure: The colloidal osmotic pressure is maintained at
around 25 mmHg by the plasma proteins like albumin.
 Nutrition: Transportation of nutrients like glucose, amino acids, lipids and vitamins
absorbed from the digestive tract to different parts of the body as a source of fuel for
growth and development.
 Respiration: Transportation of respiratory gases, i.e., carrying oxygen to the various
organs and carrying carbon dioxide back to the lungs for excretion.
 Excretion: The blood removes nitrogenous waste products produced after cellular
metabolism and transports them to the kidney, lungs, and skin for excretion.
 Hormones: Hormones are released into the blood and transported to its target organs.
 Regulation of Acid-Base Balance: Plasma proteins contribute to acid-base balance
through their buffering action.
 Regulation of Body Temperature: This is maintained through a balance between heat loss
and heat gain in the body.
 Role in Erythrocyte Sedimentation Rate (ESR): Fibrinogen, an acute phase reactant,
increases during acute inflammatory conditions and contributes to the increase in ESR,
which is used as a diagnostic and prognostic too
Referanc

 https://www.britannica.com/science/plasma-biology
 https://www.statpearls.com/kb/viewarticle/27296?utm_source=pubmed
 https://en.wikipedia.org/wiki/Blood_plasma
 https://www.google.com/search?q=plasma+blood&client=firefox-b-
d&sxsrf=ALeKk00RGO1tpZgiGTJSjdgfVQFam6lzDQ:1592397762407
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qZfVVDSI8r2M