Exploring Convalescent Plasma Therapy for COVID-19: An Interview With Prof. William Hartman

University of Wisconsin (UW) Hospital recently announced that a COVID-19 patient at the hospital had received the first transfusion of plasma from a local patient that had donated it after recovering from the disease.

This occurred as part of a nationwide study that is being conducted to explore whether convalescent plasma therapy, whereby the plasma of a recovered patient is transferred to a patient infected with SARS CoV-2, is an effective treatment strategy for COVID-19.

Technology Networks spoke with William Hartman, Professor of Anesthesiology at The UW School of Medicine and Public Health, to learn more about the history of convalescent plasma therapy, how it works, and the program that has been launched which aims to evaluate the efficacy and safety of plasma therapy in COVID-19 patients.

Laura Lansdowne (LL): For our readers that may be unfamiliar, what is convalescent plasma therapy?How does it work?

William Hartman (WH): Convalescent plasma is the transfer of plasma (the liquid part of blood) from one person to another. In this case, the transfer of plasma is transferred from a recovered COVID-19 donor to a COVID-19 sick recipient. We know that antibodies are stored in the plasma, so when an individual has been infected and recovered from COVID-19, they have a lot of Ab in their plasma that were generated to fight off the virus. The fact that the donor survived means those antibodies work really well. We hope that by collecting that plasma and transfusing it into a sick recipient, that those antibodies will help neutralize and kill the virus in the recipient as well.

LL: Has this approach been used successfully to treat other infectious diseases – if so, was this the underlying basis for exploring it as a treatment for COVID-19?

WH: Convalescent plasma has been used to treat many pandemics in history. It was used to treat diphtheria in 1901, the Spanish flu in 1913 (Nobel prize winning work), more recently, it has been used to treat the diseases SARS and MERS which are both caused by coronaviruses, and it was also used in the Ebola virus outbreak. In the absence of a vaccine, the most effective way to defeat the virus is with the antibody. The historical use and the basic knowledge that the donors have the neutralizing antibody in their plasma is the basis for using convalescent plasma to treat COVID-19.

LL: Can you elaborate on the details of the expanded access program?

WH: The expanded access program (EAP) was put forth by the US Food and Drug Administration (FDA) to allow for relatively easy access to convalescent plasma. Everyone who agrees to be part of the EAP must agree and adhere to a strict protocol drafted by the controlling body of the EAP, Mayo Clinic. By doing so, and by agreeing to register and provide follow up on treated patients, hospitals everywhere can provide this therapy for their COVID-19 patients.

Molly Campbell (MC): Please can you expand on the plans for the program, in terms of duration, anticipated number of recruits etc.?

WH: This is a compassionate care protocol, so whoever qualifies for convalescent plasma therapy, we will try to get plasma to. There is no anticipated number of recruits and the duration will be for as long as the program is necessary, hopefully until the virus is eradicated.

MC: Can you talk about the availability of convalescent plasma therapy? Would the plasma from one recovered patient be able to treat several currently diagnosed patients?

WH: Depending on how the plasma is collected, a single donor can donate enough plasma to treat two or three patients. Our only limitation to this study is the availability of donors. Donors must have had a positive COVID-19 test recorded in their record, unfortunately because we were late to efficiently test people, this number is low right now.

MC: Your team have condensed essentially ten months work into one week. Based on this experience, can you share any advice to other scientists/ institutions that are having to dramatically accelerate their work processes?

WH: The most important element is to have a dedicated team of “can-do” people who are singularly motivated to bring a concept to reality. It is also important to designate tasks to individual people or groups of people and trust that they will come through for you. Always have a plan B, if roadblocks are impeding progress on plan A, abandon it and move to plan B. There is no time to waste. In this manner, many tasks can be accomplished simultaneously, and the puzzle will have all of the pieces, it is then the job of the leadership team to fit those pieces together. Never underestimate the power of saying “thank you” either. People will work tirelessly for you if they know that they are appreciated. Finally, drink a lot of coffee.

William Hartman was speaking with Molly Campbell and Laura Elizabeth Lansdowne, Science Writers, Technology Networks.