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

Plasma transfusion is considered a relatively safe procedure, particularly if pathogen reduction is done. However, for use as a treatment of EVD, there are additional considerations. Safe production, storage, and distribution need to be organized in the affected countries. Plasmapheresis technology needs to be available or introduced, including quality-assured testing for transfusion-transmissible infections and an effective cold chain, all of which have been major challenges in the currently affected West African countries. Although standards for blood group typing are clearly defined in the national guidelines, errors can result from field realities, such as lack of resources, supervision, and poorly incentivized staff. Additionally, weak systems of documentation can lead to poor or mistaken identification.