Plasma therapy: an alternative to gamma globulin injections in immunodeficiency

The intravenous infusion of fresh-frozen plasma is an alternative to intramuscular immune serum globulin (ISG) injections. When given in doses of 15 ml/kg at 3-week intervals, the IgG levels achieved are significantly higher than those achieved by 0.7 ml/kg of ISG and they persist longer. In addition, IgM and IgA levels are raised slightly. Other advantages of plasma include the avoidance of intramuscular infections, better patient tolerance, and provision of other serum proteins. The chief disadvantages of plasma are the risk of serum hepatitis (which can be minimized by donor selection) and the inconvenience of procurement and administration. However, it is the treatment of choice for Wiskott-Aldrich syndrome, certain opsonic deficiencies and patients refractory, sensitive or unable to have ISG injections.