Aseguramiento del abastecimiento de sangre, recambio plasmático terapéutico y plasma convaleciente durante la pandemia de COVID-19

Inicio>>Volumen>>Vol 26, N ° 1 enero – abril 2021>>Aseguramiento del abastecimiento de sangre, recambio plasmático terapéutico y plasma convaleciente durante la pandemia de COVID-19

Aseguramiento del abastecimiento de sangre, recambio plasmático terapéutico y plasma convaleciente durante la pandemia de COVID-19


Ana Julia Moraga-Salazar, Esteban Castro-Artavia, José Pablo Mora-Fallas


La pandemia del SARS-CoV-2 ha provocado un aumento repentino y sustancial alrededor del mundo de pacientes hospitalizados por neumonía con fallas multiorgánicas. Esta revisión discute el papel del microbiólogo en los bancos de sangre de Costa Rica en el aseguramiento del abastecimiento de sangre, recambio plasmático terapéutico y manejo del plasma convaleciente durante la pandemia.

Palabras clave

Recambio plasmático terapéutico, plasma convaleciente, donación de sangre, banco de sangre y COVID-19.


The SARS-CoV-2 pandemic has caused a sudden and substantial increase of hospital patients with pneumonia and multi-organ failure around the world. This review discusses the role of the microbiologist in blood banks in Costa Rica, regarding blood supply management, therapeutic plasma exchange, and management of convalescent plasma during the pandemic.

Key words

Therapeutic plasma exchange, convalescent plasma, blood donation, blood bank, COVID-19.

Texto completo



1. Ling L, Wei Z, Yu H, Tong X, Zheng S, Yang J, et al. Effect of Convalescent PlasmaTherapy on Time to Clinical Improvement in Patients with Severe and Life-threatening COVID-19: A Randomized Clinical Trial. JAMA - J Am Med Assoc. 2020;E1–11.
2. Ministerio de Salud. Costa Rica. Situación Nacional Covid. 2020. Disponible en : visitado 30 agosto 2020
3. Chenguang S, Zhaoqin W, Zhao F, Yang Y, Li J, Yuan J, et al. Treatment of 5 Critically Ill Patients with COVID-19 with Convalescent Plasma. JAMA - J Am Med Assoc. 2020; 323(16):1582–9.
4. World Health Organization. Protecting the blood supply during infectious disease outbreaks: guidance for national blood services. 2020 [cited 2020 Sep 1]. Disponible en:
5. World Health Organization. Guidance on maintaining a safe and adequate blood supply during the coronavirus disease 2019 (COVID-19) pandemic and on the collection of COVID-19 convalescent plasma. World Heal Organ Interim Guid. 2020;July(10):1–6.
6. Beth S, BenAvram D. Association Bulletin #20-02 - Recommendations for Providing a Safe Environment for Blood Donation During the COVID-19 Epidemic. 2020. 2–3. Disponoble en:
7. Ministerio de Salud. Costa Rica. Lineamientos para los Servicios de Sangre Públicos y Privados en el Marco de la Alerta Sanitaria por Coronavirus (COVID-19). 2020. Disponible en: v2_20032020.pdf
8. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506.
9. Kwon SY, Kim EJ, Jung YS, Jang JS, Cho NS. Post-donation COVID-19 identification in blood donors. Vox Sang. 2020;1–2.
10. Katz LM. Is SARS-CoV-2 transfusion transmitted? Transfusion. 2020;60(6):1111–4.
11. Chen X, Zhao B, Qu Y, Chen Y, Xiong J, Feng Y, et al. Detectable serum SARS-CoV-2 viral load (RNAaemia) is closely correlated with drastically elevated interleukin 6 (IL-6) level in critically ill COVID-19 patients. Clin Infect Dis. 2020:13–5. Disponible en: doi: 10.1093/cid/ciaa449
12. U.S. Food and Drugs Administration. Updated Information for Blood Establishments Regarding the Novel Coronavirus Outbreak. 2020. 1–3. Disponible en:
13. Molina-Ulloa S, Valerín-Cháves A. Lineamiento Técnico para la Recolección y Procesamiento de Plasma Convaleciente COVID-19 (PCC). 2020. Disponible en:
14. Ou-Yang J, Li SJ, Bei C hua, He B, Chen J yan, Liang H qin, et al. Blood Donor Recruitment in Guangzhou, China, during the 2019 Novel Coronavirus (COVID-19) Epidemic. Transfusion. 2020. Abril:1–14.
15. Pagano MB, Hess JR, Tsang HC, Staley E, Gernsheimer T, Sen N, et al. Prepare to adapt: blood supply and transfusion support during the first 2 weeks of the 2019 novel coronavirus (COVID-19) pandemic affecting Washington State. Transfusion. 2020;60(5):908–11.
16. Wang Y, Han W, Pan L, Wang C, Liu Y, Hu W, et al. Impact of COVID-19 on blood centres in Zhejiang province China. Vox Sang. 2020;1–5.
17. U.S. Food and Drugs Administration. Revised recommendations for reducing the risk of Zika virus transmission by blood and blood components. Guidance for industry. 2020. Disponible en:
18. Beth Shaz, BenAvram D. Association Bulletin #20-03 - Emergent Standards to the 31st and 32nd editions of Standards for Blood Banks and Transfusion Services. 2020. Disponible en from:
19. Raturi M, Kusum A. The blood supply management amid the COVID-19 outbreak. Transfus Clin Biol. 2020;27(3):147–51. Disponible en:
20. Cai X, Ren M, Chen F, Li L, Lei H, Wang X. Blood transfusion during the COVID-19 outbreak. Blood Transfus. 2020;18(2):79–85.
21. Shander A, Goobie SM, Warner MA, Aapro M, Bisbe E, Perez-Calatayud AA, et al. Essential Role of Patient Blood Management in a Pandemic: A Call for Action. Anesth Analg. 2020;131(1):74–85.
22. Baron DM, Franchini M, Goobie SM, Javidroozi M, Klein AA, Lasocki S, et al. Patient blood management during the COVID–19 pandemic: a narrative review. Anaesthesia. 2020;75(8):1105–13.
23. Singh G, Nahirniak S, Arora R, Légaré J-F, Kanji H, Nagpal D, et al. Transfusion Thresholds for Adult Respiratory Extracorporeal Life Support: An Expert Consensus Document. Can J Cardiol. 2020;( July):10–3.
24. Stanworth SJ, New H V, Apelseth TO, Brunskill S, Cardigan R, Doree C, et al. Effects of the COVID-19 pandemic on supply and use of blood for transfusion. Lancet Haematol- 2020;3026(theme 2):1–9. Disponible en:
25. Abdel-Wahab OI, Healy B, Dzik WH. Effect of fresh-frozen plasma transfusion on prothrombin time and bleeding in patients with mild coagulation abnormalities. Transfusion. 2006;46(8):1279–85.
26. Dunbar NM, Yazer MH, Carey PM, Christie JD, Fadeyi EA, Fontaine MJ, et al. Safety of the use of group A plasma in trauma: the STAT study. Transfusion. 2017;57(8):1879–84.
27. Nickel RS, Margulies S, Frazer B, Luban NLC, Webb J. Combination dose-escalated hydroxyurea and transfusion: an approach to conserve blood during the COVID-19 pandemic. Blood. 2020;135(25):2316–9.
28. Slichter SJ, Kaufman RM, Assmann SF, McCullough J, Triulzi DJ, Strauss RG, et al. Dose of prophylactic platelet transfusions and prevention of hemorrhage. N Engl J Med. 2010;362(7):600–13.
29. Ljungman P, Mikulska M, de la Camara R, Basak GW, Chabannon C, Corbacioglu S, et al. The challenge of COVID-19 and hematopoietic cell transplantation; EBMT recommendations for management of hematopoietic cell transplant recipients, their donors, and patients undergoing CAR T-cell therapy. Bone Marrow Transplant. 2020; Disponible en:
30. Slichter SJ, Bolgiano D, Corson J, Jones MK, Christoffel T, Bailey SL, et al. Extended storage of buffy coat platelet concentrates in plasma or a platelet additive solution. Transfusion. 2014;54(9): 2283–91.
31. Stolla M, Fitzpatrick L, Gettinger I, Bailey SL, Pellham E, Christoffel T, et al. In vivo viability of extended 4°C-stored autologous apheresis platelets. Transfusion. 2018; 58(10): 2407–13.
32. Tay MZ, Poh CM, Rénia L, MacAry PA, Ng LFP. The trinity of COVID-19: immunity, inflammation and intervention. Nature Reviews Immunology. 2020;20: 363–74.
33. Wong CK, Lam CWK, Wu AKL, Ip WK, Lee NLS, Chan IHS, et al. Plasma inflammatory cytokines and chemokines in severe acute respiratory syndrome. Clin Exp Immunol. 2004; 136(1): 95–103.
34. Hsueh-Limg J, Gan SKE, Bertoletti A, Tan YJ. Understanding the T cell immune response in SARS coronavirus infection. 2020, 1: Emerging Microbes and Infections. Taylor & Francis; 2012; 1(9); 23.
35. Tabibi S, Tabibi T, Conic RRZ, Banisaeed N, Streiff MB. Therapeutic Plasma Exchange: A potential Management Strategy for Critically Ill COVID-19 Patients. Journal of Intensive Care Medicine. 2020;35: 827–35.
36. Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest. 2020;130(5): 2620–9.
37. Zhou Y, Fu B, Zheng X, Wang D, Zhao C, Qi Y, et al. Pathogenic T-cells and inflammatory monocytes incite inflammatory storms in severe COVID-19 patients. Natl Sci Rev. 2020;c7(6):998–1002.
38. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229):1054–62.
39. Levi M, Thachil J, Iba T, Levy JH. Coagulation abnormalities and thrombosis in patients with COVID-19. The Lancet Haematology. 7; 2020: 438–40.
40. Gavriilaki E, Brodsky RA. Severe COVID‐19 infection and thrombotic microangiopathy: success does not come easily. Br J Haematol. 2020 Jun;189(6): 227–30.
41. Chauhan A, Wiffen L, Brown T. COVID‐19: a collision of complement, coagulation and inflammatory pathways. J Thromb Haemost. 2020; 0–3.
42. Padmanabhan A, Connelly-Smith L, Aqui N, Balogun RA, Klingel R, Meyer E, et al. Guidelines on the Use of Therapeutic Apheresis in Clinical Practice - Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Eighth Special Issue. J Clin Apher. 2019;34(3):171–354.
43. Keith P, Day M, Perkins L, Moyer L, Hewitt K, Wells A. A novel treatment approach to the novel coronavirus: An argument for the use of therapeutic plasma exchange for fulminant COVID-19. Critical Care. 2020; 24 (128).
44. Stahl K, Bode C, David S. First do no harm-beware the risk of therapeutic plasma exchange in severe COVID-19. Critical care. 2020; 24(363).
45. Gucyetmez B, Atalan HK, Sertdemir I, Cakir U, Telci L. Therapeutic plasma exchange in patients with COVID-19 pneumonia in intensive care unit: a retrospective study. Crit Care. 2020;24(1):1–4.
46. Khamis F, Al-Zakwani I, Al Hashmi S, Al Dowaiki S, Al Bahrani M, Pandak N, et al. Therapeutic Plasma Exchange in Adults with Severe COVID-19 Infection. Int J Infect Dis. 2020; 99: 214-218.
47. Kesici S, Yavuz S, Bayrakci B. Get rid of the bad first: Therapeutic plasma exchange with convalescent plasma for severe COVID-19. Proceedings of the National Academy of Sciences of the United States of America. National Academy of Sciences; 2020.(117): 12526–7.
48. Malkovsky M. Therapeutic Plasma Exchange-Neutralizing Antibody Combination Therapy for Severe Coronavirus Disease 2019. J Infect Dis. 2020 Jul; 222(3):509–10.
49. Joyner MJ, Senefeld JW, Klassen SA, Mills JR, Johnson PW, Theel ES, et al. Effect of Convalescent Plasma on Mortality among Hospitalized Patients with COVID-19: Initial Three-2 Month Experience. medRxiv. 2020. Disponible en
50. Focosi D, Tang J, Anderson A, Tuccori M. Convalescent Plasma Therapy for Covid-19: State of the Art. Clin Microbiol Rev. 2020; 33(4):1–17.
51. Franchini M, Marano G, Velati C, Pati I, Pupella S, Liumbruno GM. Operational protocol for donation of anti-COVID-19 convalescent plasma in Italy. Vox Sang. 2020; 116(1) 136-137.
52. Casadevall A, Joyner MJ, Pirofski LA. A Randomized Trial of Convalescent Plasma for COVID-19 - Potentially Hopeful Signals. JAMA - J Am Med Assoc. 2020; 324(5):455–7.
53. Duan K, Liu B, Li C, Zhang H, Yu T, Qu J, et al. Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proc Natl Acad Sci U S A. 2020; 117(17): 9490–6.
54. Mingxiang Y, Dian F, Yi R, Wang F, Wang D, Zhang F, et al. Treatment with convalescent plasma for COVID-19 patients in Wuhan, China. J Med Virol. 2020; 92(10): 1890-1901.
55. Liu S, Lin H-M, Baine I, Wajnberg A, Gumprecht JP, Rahman F, et al. Convalescent plasma treatment of severe COVID-19: A matched control study. medRxiv. 2020. Disponible en: