Ebola virus convalescent blood products: where we are now and where we may need to go

Abstract

The world is regularly exposed to emerging infections with the potential to burst into a pandemic. One possible way to treat patients, when no other treatment is yet developed,is passive immunization performed by transfusing blood, plasma or plasma immunoglobul infractions obtained from convalescent donors who have recovered from the disease and have developed protective antibodies. The most recent on-going epidemic is caused by the Ebola virus, a filovirus responsible for Ebola virus disease, a severe, often lethal, hemorrhagic fever. Recently, the use of convalescent blood products was proposed by the WHO as one early option for treating patients with Ebola virus disease. This publication provides an overview of the various convalescent blood products and technological options that could theoretically be considered when there is a need to rely on this therapeutic approach.In countries without access to advanced blood-processing technologies, the choice may initially be restricted to convalescent whole blood or plasma. In technologically advanced countries, additional options for convalescent blood products are available, including virally inactivated plasma and fractionated immunoglobulins. The preparation of minipool immunoglobulins is also a realistic option to consider.

Fig. 1

Flow-chart presenting the various technical possibilities that currently can theoretically be considered for producing convalescent blood products. Virally-inactivated plasma and immunoglobulins can also be made from recovered plasma. *unlicensed; **developed in Egypt; ***under clinical trial in immuno-deficient patients; IgG: immunoglobulin G; CF: coagulation factors; alb: albumin; S/D: solvent/detergent; S/D-F: solvent/detergent-filtered; UV: ultraviolet light; VI: virally-inactivated.