Convalescent plasma transfusion

Convalescent plasma transfusion is a therapeutic approach that involves transferring plasma from individuals who have recovered from an infectious disease to patients currently suffering from the same condition. This treatment leverages the antibodies developed by recovered individuals to help fight the infection in recipients. ## Description Convalescent plasma transfusion is a treatment that provides passive immunity by transferring antibodies from a recovered donor to a patient with the same infectious disease. The plasma contains antibodies specific to the pathogen that the donor's immune system developed while fighting and recovering from the infection. These antibodies can help the recipient's body recognize and attack the infection while their own immune system develops a response[1][3]. This therapy has a long history of use in treating infectious diseases, including Spanish Influenza A (H1N1) in 1915-1917, SARS in 2003, pandemic 2009 influenza A (H1N1), avian influenza A (H5N1), Ebola, and most recently, COVID-19[5]. The treatment works by providing passive immunity - essentially "borrowing" someone else's immune defenses temporarily[1]. The procedure involves collecting plasma from donors who have fully recovered from the target disease and have developed high levels of antibodies. This plasma is then transfused into patients, typically those with severe illness or at risk of developing severe disease[1][6]. ## Administration and Dosing Convalescent plasma is administered through a peripheral or central venous catheter according to standard institutional medical and nursing practices for plasma transfusion. Clinical dosing typically starts with one unit (approximately 200 mL), with additional units administered based on the physician's judgment and patient's clinical response[9]. Patients with impaired cardiac function may require smaller volumes or more prolonged transfusion times[9]. The transfusion process can take one to four hours[1]. ## Clinical Benefits and Effectiveness Studies, particularly those conducted during the COVID-19 pandemic, have shown several potential benefits of convalescent plasma therapy: 1. Reduction in mortality in critically ill patients[5] 2. Increase in neutralizing antibody titers in recipients[5] 3. Disappearance of viral RNA in most patients after therapy[5] 4. Improvement in clinical symptoms, including normalization of body temperature, absorption of lung lesions, and resolution of acute respiratory distress syndrome (ARDS)[5] 5. Weaning from ventilation within varying timeframes post-transfusion[5] The effectiveness of convalescent plasma therapy appears to be time-sensitive, with greater benefits observed when administered early in the disease course, ideally within the first 9 days of symptom onset and optimally within 72 hours[6]. ## Indications While there are no universal eligibility criteria, convalescent plasma is generally considered appropriate for: 1. Patients with severe disease course or at risk of severe disease[6] 2. Life-threatening conditions related to the infectious disease[6] 3. Patients with immunosuppressive disease or receiving immunosuppressive treatment[9] 4. Early stages of infection (ideally within 72 hours of symptom onset)[6] Specific clinical criteria that may indicate eligibility include: - Dyspnea - Respiratory rate ≥ 30/min - Blood saturation ≤ 93% - PaO2/FiO2 < 300 - Lung infiltration > 50% within 24-48 hours - Respiratory failure - Septic shock - Multi-organ failure[6] ## Contraindications Convalescent plasma therapy is generally not recommended for: - Patients with disease duration of more than 3 weeks (with exceptions for immunocompromised patients)[6] - Patients with contraindications to standard plasma transfusion ## Storage and Handling Convalescent plasma can be stored frozen at -18°C or colder with an expiration date of one year from collection. Once thawed, it can be refrigerated for up to 5 days prior to transfusion[9]. ## Regulatory Status For COVID-19, the FDA issued an Emergency Use Authorization (EUA) for convalescent plasma with high titers of anti-SARS-CoV-2 antibodies for treating COVID-19 in patients with immunosuppressive disease or receiving immunosuppressive treatment, in both outpatient and inpatient settings[9].

Other names

Convalescent plasma