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迅速制定全新恢复期血浆计划以应对全球大流行:美国东南部大型血库的经验。

Rapid development of a de novo convalescent plasma program in response to a global pandemic: A large southeastern U.S. blood center's experience.

机构信息

Administration, IT and Scientific/Medical/Technical Divisions, OneBlood, St. Petersburg, Florida, USA.

Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA.

出版信息

J Clin Apher. 2021 Aug;36(4):533-546. doi: 10.1002/jca.21889. Epub 2021 Mar 1.

Abstract

BACKGROUND

During the pandemic in the spring of 2020 with no vaccine or treatment for SARS-CoV-2 and its associated disease, COVID-19, convalescent plasma from recovered COVID-19 (CCP) patients offered a potential therapy. In March 2020, the United States (U.S.) Food and Drug Administration (FDA) authorized CCP under emergency Investigational New Drug (eIND) exemption and an IRB-approved Expanded Access Program (EAP) to treat severe COVID-19. Hospital demand grew rapidly in the Southeastern U.S., resulting in backlogs of CCP orders. We describe a large U.S. blood center's (BC) rapid implementation of a CCP program in response to community needs.

STUDY DESIGN AND METHODS

From April 2 to May 17, 2020, CCP was collected by whole blood or apheresis. Initial manual approaches to donor intake, collection, and distribution were rapidly replaced with automated processes. All CCP donors and products underwent FDA-required screening and testing.

RESULTS

A total of 619 CCP donors (299 females, 320 males) presented for CCP donation (161 [25.7%] whole blood, 466 [74.3%] plasmapheresis) resulting in 1219 CCP units. Production of CCP increased as processes were automated and streamlined, from a mean of 11 donors collected/day for the first month to a mean of 25 donors collected/day in the subsequent 2 weeks. Backlogged orders were cleared, and inventory began to accumulate 4 weeks after project initiation.

CONCLUSION

The BC was able to implement an effective de novo CCP collection program within 6 weeks in response to a community need in a global pandemic. Documentation of the experience may inform preparedness for future pandemics.

摘要

背景

在 2020 年春季的大流行期间,由于没有针对 SARS-CoV-2 及其相关疾病 COVID-19 的疫苗或治疗方法,因此康复的 COVID-19(CCP)患者的恢复期血浆提供了一种潜在的治疗方法。2020 年 3 月,美国(U.S.)食品和药物管理局(FDA)授权 CCP 在紧急情况下进行调查性新药(eIND)豁免和经 IRB 批准的扩大准入计划(EAP),以治疗严重的 COVID-19。美国东南部的医院需求迅速增长,导致 CCP 订单积压。我们描述了一家大型美国血液中心(BC)如何迅速实施 CCP 计划以满足社区需求。

研究设计与方法

从 2020 年 4 月 2 日至 5 月 17 日,通过全血或单采术采集 CCP。最初采用的手动方法来进行供体摄入,采集和分配,后来迅速被自动化过程所取代。所有 CCP 供体和产品均经过 FDA 要求的筛选和测试。

结果

共有 619 名 CCP 供体(299 名女性,320 名男性)参加了 CCP 捐赠(161 名[25.7%]全血,466 名[74.3%]血浆单采术),共产生了 1219 个 CCP 单位。随着流程的自动化和简化,CCP 的产量不断增加,第一个月平均每天采集 11 名供体,随后的 2 周内平均每天采集 25 名供体。积压的订单得到了清理,并且在项目启动后的 4 周内开始积累库存。

结论

在全球大流行期间,BC 能够在 6 周内实施有效的新 CCP 采集计划,以满足社区的需求。该经验的记录可能为未来的大流行做好准备。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f546/8451926/4f5e307061fb/JCA-36-533-g001.jpg

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