Vitalant Research Institute, San Francisco, California, USA.
Department of Management Science and Engineering, Stanford University, Stanford, California, USA.
Transfusion. 2021 May;61(5):1370-1376. doi: 10.1111/trf.16317. Epub 2021 Feb 16.
COVID-19 Convalescent Plasma (CCP) is a promising treatment for COVID-19. Blood collectors have rapidly scaled up collection and distribution programs.
We developed a detailed simulation model of CCP donor recruitment, collection, production, and distribution processes. We ran our model using varying epidemic trajectories from 11 U.S. states and with key input parameters drawn from wide ranges of plausible values to identify key drivers of ability to scale collections capacity and meet demand for CCP.
Utilization of available CCP collections capacity followed increases in COVID-19 hospital discharges with a lag. Utilization never exceeded 75% of available capacity in most simulations. Demand was met for most of the simulation period in most simulations, but a substantial portion of demand went unmet during early, sharp increases in hospitalizations. For epidemic trajectories that included multiple epidemic peaks, second wave demand could generally be met due to stockpiles established during the decline from an earlier peak. Apheresis machine capacity (number of machines) and probability that COVID-19 recovered individuals are willing to donate were the most important supply-side drivers of ability to meet demand. Recruitment capacity was important in states with early peaks.
Epidemic trajectory was the most important determinant of ability to meet demand for CCP, although our simulations revealed several contributing operational drivers of CCP program success.
COVID-19 恢复期血浆(CCP)是治疗 COVID-19 的一种很有前途的方法。血液采集人员迅速扩大了采集和分发计划。
我们开发了一个详细的 CCP 供体招募、采集、生产和分发过程模拟模型。我们使用来自 11 个美国州的不同疫情轨迹和广泛的合理范围内的关键输入参数运行我们的模型,以确定扩大采集能力和满足 CCP 需求的关键驱动因素。
在 COVID-19 住院出院人数增加的情况下,可用的 CCP 采集能力得到了利用,但存在滞后。在大多数模拟中,利用率从未超过可用容量的 75%。在大多数模拟中,大部分时间都能满足需求,但在住院人数急剧增加的早期,仍有相当一部分需求未得到满足。对于包括多个疫情高峰的疫情轨迹,由于在从早期高峰下降期间建立的库存,第二波需求通常可以得到满足。单采机容量(机器数量)和 COVID-19 康复个体愿意捐赠的概率是满足需求能力的最重要的供应方驱动因素。在早期出现高峰的州,招募能力很重要。
疫情轨迹是满足 CCP 需求的最重要决定因素,但我们的模拟揭示了 CCP 项目成功的几个运营驱动因素。