September 6, 2012 Kamada Ltd. Science Park Kiryat Weizmann

Exhibit 10.21

September 6, 2012

Kamada Ltd.

Science Park

Kiryat Xxxxxxxx

0 Xxxxx Xx. X.X Xxx 0000

Xxxx Xxxxx 00000, Xxxxxx

Attention: Chief Executive Officer

Re:       First Amendment (the “First Amendment”) to that EXCLUSIVE MANUFACTURING, SUPPLY AND DISTRIBUTION AGREEMENT (the “Agreement”) dated August 23, 2010 between Kamada Ltd. (“Kamada”) and Xxxxxx Healthcare Corporation (“Baxter”)

Subject to the full execution of this First Amendment, effective as of the date of the last signature, Baxter and Xxxxxx hereby agree to the following:

The parties agree that Section 11.4(d) of this Agreement is modified to read as follows,

“Notification of Complaints. Upon any Party receiving or becoming aware of any complaint involving the A1PI IV Product, it shall act in accordance with the terms of Section 13 (Table No. 7) of the Quality Agreement signed between the Parties on September 23, 2010, as may be amended by the Parties from time to time”.

Except as specifically amended by this Amendment, all other terms and conditions of the Agreement shall continue in full force and effect during the Term of the Agreement.

If the foregoing terms and conditions are acceptable, please sign and date both originals of this First Amendment and return one (1) original to Baxter.

Sincerely,			ACCEPTED:
Xxxxxx Healthcare Corporation			Kamada Ltd.
By:	/s/ Xxxxxx Xxxxxxx		By:	/s/ GIL EFRON	/s/ Xxxxx Xxxx
Name:	Xxxxxx Xxxxxxx		Name:	GIL EFRON	Xxxxx Xxxx
Title:	CVP, President BioScience		Title:	CFO	CEO
Date:	Sept 4, 2012		Date:	Oct 15, 0000	00.00.00