Parachuting plasmapheresis into the Ebola crisis

Abstract

BACKGROUND The Safe Blood for Africa Foundation™ (SBFA) supported Blood Safety for a clinical trial on Ebola Convalescent Plasma (ECP) during the Ebola crisis in Liberia in 2014. Several technical challenges needed to be met and interaction with Ebola survivors who were willingly donors.
OBJECTIVES To setup the first plasmapheresis and pathogen inactivation technology in West Africa to harvest Ebola Convalescent Plasma (ECP) for a clinical trial.
MATERIALS AND METHODS An initial team of four was deployed (November 2014) to set the facility. A vehicle was pre-fitted with sophisticated equipment and airlifted to the study site (ELWA). Survivor donors were sourced via the Hospital Medical Director. Training included plasmapheresis, donor management, testing and pathogen inactivation.
RESULTS The unit was set up in three weeks. Three Liberian technicians were trained in blood safety. Rapid declining new infections ended the trial. ECP was collected until May 2015 with 97 participants (19 – 67yr), 42% female and blood group profiles matching those for West Africa and African Americans (O Pos 57% & B Pos 20%) with only one Rh Neg unit. Eighty five full-volume units were collected with a 90.4% success rate and repeat donors contributed 39 units with no adverse effects recorded.
CONCLUSION The conflict between expectations of the research team and realities of extreme resource constraints were overcome in the context of Ebola in a very low Human Development Index (HDI) country. Increased deployment of apheresis technology in West Africa needs consideration given 600kl of plasma is discarded in Africa each year.