The Use of Ebola Convalescent Plasma to Treat Ebola Virus Disease in Resource-Constrained Settings: A Perspective From the Field

van Griensven, Johan; De Weiggheleire, Anja; Delamou, Alexandre; Smith, Peter G.; Edwards, Tansy; Vandekerckhove, Philippe; Bah, Elhadj Ibrahima; Colebunders, Robert; Herve, Isola; Lazaygues, Catherine; Haba, Nyankoye; Lynen, Lutgarde

The World Health Organization (WHO) guidelines recommend both convalescent whole blood (CWB) and CP for use against Ebola virus disease (EVD) [12] . During EVD outbreaks, both are local and readily available sources of anti-EVD antibodies. Blood transfusion is routinely done in all 3 high-transmission countries involved in the current EVD outbreak; however, plasma has numerous advantages in these settings. Using apheresis, a single donor can give substantially more CP, up to 10 mL/kg every 2 weeks, compared with 1 unit of 450 mL whole blood (approximately 250 mL plasma) every 3-4 months for CWB; hence, more patients can be treated. CP can be given intravenously over a much shorter time period (30 minutes vs 3-4 hours) and hence is less demanding for healthcare teams in Ebola treatment centers. The pathogen inactivation step during CP production increases the safety of the intervention. CP transfusion is also safer with fewer transfusion reactions; CP needs to be ABO compatible, but there is no need for bedside cross-matching [13] . Additionally, CP can be stored for much longer periods.