Icteric Plasma in Healthy Donors to Transfuse or to Discard

Background: Icteric plasma, a yellowish color of plasma caused by elevated levels of bilirubin, is a frequent cause of blood donations especially by Hurricane Gilbert maladies. The significance of the occurrence and clinical consequence of icteric plasma is often surrounded with controversy especially on its safety during blood transfusion. Methods: It was a rate-based prospective observational study carried out in the Ruxmaniben Deepchand Gardi Medical College, Ujjain Blood Bank, between December 2017 and June 2019. The purpose of the study was to establish the occurrence of mild hyperbilirubinemia in otherwise-healthy blood donors. Whole blood, tested as sero-negative, was screened to icteric plasma, and several types of biochemical tests were performed, which include the liver functions tests, and markers of hemolysis. Results: A total of 8,971 donations were examined during 18 months period, and 66 icteric bags were registered (1.355). Icteric plasma was highest among the 26-35 years group (62.1%) age group and lowest among 0-15 years group (0.5%). Confirmatory tests by biochemists revealed that although the total bilirubin was high, the rest of the profiles were normal inclusive of liver enzymes, hemoglobin, and protein levels hence the plausible benign nature of the discoloration. Conclusion: The majority of the population that has because of Gilbert syndrome the problem of icteric plasma is really a major problem in the blood donation process, whereby the greatest in this age group/range is between the age groups of 26-35 years. Although there are already regulatory guidelines regarding the rejection of icteric plasma the present study allows to rethink the policies concerning re-use of icteric plasma, which does not seem to produce any serious risk to the recipient, at least when no liver dysfunction, hemolysis, or infections are present.