Plasma Transfusion Not Associated with Increased Survival in Patients With Ebola

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Transfusions with convalescent plasma may not increase the survival rate among Ebola patients.
Transfusions with convalescent plasma may not increase the survival rate among Ebola patients.

Treating patients with Ebola with plasma transfused from survivors of the illness was feasible to administer during the Ebola virus disease outbreak, but it was not associated with increased survival among one patient population, according to a study conducted by the Ebola Treatment Unit in Conakry, Guinea.

After the Ebola outbreak was declared in March 2014, World Health Organization (WHO) officials prioritized the evaluation of treatment with convalescent whole blood or plasma from recovered patients with Ebola, since this method has been successful for other serious infectious diseases. The researchers evaluated the use of convalescent plasma to determine its efficacy and safety for treating patients with Ebola.

The researchers gave 99 confirmed patients with Ebola, including some pregnant women, 2 consecutive transfusions of ABO-compatible convalescent plasma. Each plasma unit was obtained from a separate convalescent plasma donor, and patients received transfusion treatment up to 2 days after their diagnosis.

At the beginning of the study, the patients who received convalescent plasma transfusions had slightly higher cycle-threshold values and a shorter duration of symptoms than the control group. They also had a higher frequency of eye redness and difficulty swallowing.

Between day 3 and day 16 of treatment, the risk of death was 31% among the patients who received convalescent plasma transfusions and 38% in the control group (risk difference, –7%; 95% confidence interval [CI], –18 to 4). This difference was reduced after the researchers adjusted for age and cycle-threshold value (adjusted risk difference, –3%; 95% CI, –13 to 8).

“It remains to be assessed whether plasma with high levels of EBOV-neutralizing antibodies, possibly administered repeatedly, would show efficacy and whether subgroups of patients, such as young children and pregnant women, would be more likely to benefit,” the authors noted in their study, published in The New England Journal of Medicine.

Reference

1.      van Griensven J, Edwards T, de Lamballerie X, et al. Evaluation of Convalescent Plasma for Ebola Virus Disease in Guinea. N Eng J Med. 2016;374:33-42. doi: 10.1056/NEJMoa1511812.

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