Method essence
The plasma of recovered patients contains antibodies to the virus, which, when administered to the patient, help the immune system to resist and have a powerful healing effect on patients in serious condition. Under normal conditions of the fight against the virus, the body takes 1-2 weeks to develop its own antibodies, which remain in the blood for a long time and come into battle every time it encounters a virus.
Upon plasma transfusion, the patient immediately receives ready-made antibodies to the virus (the so-called passive immunity), but they will act discretely from several weeks to several months.
What is the procedure
The plasma harvesting procedure is called plasmapheresis and takes only 40 minutes. The donor must provide a medical report on the previous infection with COVID-19. From the moment of the second negative test to the moment of delivery of plasma, an average of two weeks should pass. Classic contraindications: weight less than 50 kg, burdened history of diseases of the cardiovascular system, gastrointestinal tract and thyroid gland, myopia greater than -8. A year should pass from the moment of giving birth, from the moment of the end of lactation - six months. HIV, AIDS, hepatitis, syphilis in history are also direct contraindications to donation.
© Morris MacMatzen
How plasma is collected
A COVID-19 patient comes to a blood transfusion center, fills out a questionnaire like a classic donor, drinks tea with cookies. Before donating plasma, the donor must donate blood from a finger for hemoglobin. After that, he is invited to the treatment room, where 600 ml of blood is taken through a vein puncture, run through a special centrifuge, the plasma is separated, and the remaining blood cells are returned to the donor. It is in the plasma that antibodies to the cells of the new SARS-CoV-2 virus are contained.
The procedure is easily tolerated. One donor can help three patients at once. After standard checks (for all the same HIV, hepatitis, etc.), donor plasma is transfused to patients with coronavirus in severe and moderate condition.
Experience from other countries
Chinese doctors were the first to treat COVID-19 using the plasma of convalescent donors (i.e., recovered). Back in mid-February, the head of the Jinyintan Hospital in Wuhan, Zhang Dingyu, announced the first ten transfusions and the first positive results, and called on all those who recovered to become plasma donors. The method was developed by the China National Biotec Group (CNBG), a division of Sinopharm, one of the largest pharmacological conglomerates in China.
According to the observations of Chinese doctors, after a transfusion, the clinical picture changes in the next few hours. And after a day, the indicator of inflammatory processes is significantly reduced. The proportion of lymphocytes in the blood increases, the degree of oxygen saturation increases, and the viral load on the body is getting better.
The US Drug and Food Administration (FDA), despite not yet completed clinical trials of this method, on March 24 announced the provision of access to plasma of patients with COVID-19 in serious condition. The physician must obtain FDA approval for plasma treatment for each patient. 11 people in critical condition were the first in the United States to receive donor plasma in hospitals in New York and Houston. A group of American scientists, meanwhile, is preparing to begin clinical trials of therapy using plasma from recovered patients to prove its effectiveness. And the US Red Cross is launching a blood collection campaign among those who have recovered.
Following the United States, the Israeli national medical service Magen David Adom (MaDA), which deals with disaster medicine, announced the collection of blood from those who recovered from the coronavirus in late March. Due to the extremely small number of patients recognized as completely healthy in Israel (132 people, according to the data at the start of the program on March 30), the head of the MaDA blood service, Professor Eilata Shinara, believes: in order to have the necessary supply from each recovered patient, you need to get 3 units plasma volume of 500-600 ml. The first portion of plasma with antibodies to SARS-CoV-2 was received in Israel on April 1.
© Morris MacMatzen
Implementation of the procedure in Russia
On April 9, Moscow authorities announced the first Russian experience of plasma transfusion for COVID-19 patients from those who had been cured. Seven critically ill patients received plasma from the first 11 recovered donors at the N. N. Sklifosovsky Research Institute for Emergency Medicine and City Clinical Hospital No. 52. The Moscow Department of Health has ratified the method and on April 1 issued an order "On the introduction of technology for the use of fresh frozen plasma from COVID-19 convalescent donors." The document regulates the requirements for the selection of donors, the organization of the plasma procurement process, its storage and distribution.
On April 13, Alexander Kostin, head of the department of clinical and industrial transfusiology and gravitational blood surgery of the N. V. N. V. Sklifosovsky, “now there will be more and more people who have recovered from COVID-19. It is very important that they respond to our request for examination and get involved in the donation of plasma."
Where can I donate plasma
At the moment, in Russia, the plasmapheresis procedure in favor of patients with COVID-19 is carried out by three institutions.
In Moscow:
Blood Center Research Institute of Emergency Medicine. N. V. Sklifosovsky
City Clinical Hospital No. 52
In St. Petersburg:
City blood transfusion station.