Yarava Anusha, Marshall Christi, Reichert David E, Ye Aaron, Khanal Preeti, Robbins Sanford H, Sachais Bruce S, Oh David, Metcalf Ryan A, Conry-Cantilena Kathleen, King Karen, Reyes Meredith, Adamski Jill, Marques Marisa B, Tran Minh-Ha, Allen Elizabeth S, Pach Daniel, Blumberg Neil, Hobbs Rhonda, Nash Tammon, Shenoy Aarthi G, Mosnaim Giselle S, Fukuta Yuriko, Patel Bela, Heath Sonya L, Levine Adam C, Meisenberg Barry R, Anjan Shweta, Huaman Moises A, Blair Janis E, Currier Judith S, Paxton James H, Rausch William, Oei Kevin, Abinante Matthew, Forthal Donald N, Zand Martin S, Kassaye Seble G, Cachay Edward R, Gebo Kelly A, Shoham Shmuel, Casadevall Arturo, McBee Nichol A, Amirault Daniel, Wang Ying, Hopkins Erica, Shade David M, Layendecker Oliver, Klein Sabra L, Park Han-Sol, Lee John S, Caturegli Patrizio, Raval Jay S, Cruser Daniel, Ziman Alyssa F, Gerber Jonathan, Gniadek Thomas J, Bloch Evan M, Tobian Aaron A R, Hanley Daniel F, Sullivan David J, Lane Karen
Department of Neurology, BIOS Clinical Trial Coordinating Center, Trial Innovation Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
J Clin Transl Sci. 2024 Nov 14;8(1):e200. doi: 10.1017/cts.2024.642. eCollection 2024.
In response to the COVID-19 pandemic, we rapidly implemented a plasma coordination center, within two months, to support transfusion for two outpatient randomized controlled trials. The center design was based on an investigational drug services model and a Food and Drug Administration-compliant database to manage blood product inventory and trial safety.
A core investigational team adapted a cloud-based platform to randomize patient assignments and track inventory distribution of control plasma and high-titer COVID-19 convalescent plasma of different blood groups from 29 donor collection centers directly to blood banks serving 26 transfusion sites.
We performed 1,351 transfusions in 16 months. The transparency of the digital inventory at each site was critical to facilitate qualification, randomization, and overnight shipments of blood group-compatible plasma for transfusions into trial participants. While inventory challenges were heightened with COVID-19 convalescent plasma, the cloud-based system, and the flexible approach of the plasma coordination center staff across the blood bank network enabled decentralized procurement and distribution of investigational products to maintain inventory thresholds and overcome local supply chain restraints at the sites.
The rapid creation of a plasma coordination center for outpatient transfusions is infrequent in the academic setting. Distributing more than 3,100 plasma units to blood banks charged with managing investigational inventory across the U.S. in a decentralized manner posed operational and regulatory challenges while providing opportunities for the plasma coordination center to contribute to research of global importance. This program can serve as a template in subsequent public health emergencies.
为应对新冠疫情,我们在两个月内迅速设立了一个血浆协调中心,以支持两项门诊随机对照试验的输血工作。该中心的设计基于一个研究性药物服务模式以及一个符合美国食品药品监督管理局要求的数据库,用于管理血液制品库存和试验安全性。
一个核心研究团队采用了一个基于云的平台,将患者分配随机化,并追踪来自29个献血采集中心的不同血型的对照血浆和高滴度新冠康复者血浆的库存分配情况,这些血浆直接供应给为26个输血点服务的血库。
我们在16个月内进行了1351次输血。每个站点数字库存的透明度对于促进血型匹配血浆的鉴定、随机化以及连夜运输以输给试验参与者至关重要。虽然新冠康复者血浆增加了库存挑战,但基于云的系统以及血浆协调中心工作人员在血库网络中的灵活方法,使得能够分散采购和分发研究性产品,以维持库存阈值并克服各站点的当地供应链限制。
在学术环境中,为门诊输血迅速创建血浆协调中心的情况并不常见。以分散方式向负责管理美国各地研究性库存的血库分发超过3100个血浆单位,既带来了运营和监管挑战,同时也为血浆协调中心提供了为具有全球重要性的研究做出贡献的机会。该项目可作为后续公共卫生紧急情况的模板。