Objectives: Convalescent plasma (CP) as a passive source of neutralizing antibodies and immunomodulators is a century-old therapeutic option used for the management of viral diseases. We investigated its effectiveness for the treatment of COVID-19. Design: Open-label, parallel-arm, phase II, multicentre, randomized controlled trial. Setting: Thirty-nine public and private hospitals across India. Participants: Hospitalized, moderately ill confirmed COVID-19 patients (PaO2/FiO2: 200-300 or respiratory rate > 24/min and SpO2 ≤ 93% on room air). Intervention: Participants were randomized to either control (best standard of care (BSC)) or intervention (CP + BSC) arm. Two doses of 200 mL CP was transfused 24 hours apart in the intervention arm. Main Outcome Measure: Composite of progression to severe disease (PaO2/FiO2<100) or all-cause mortality at 28 days post-enrolment. Results: Between 22 nd April to 14 th July 2020, 464 participants were enrolled; 235 and 229 in intervention and control arm, respectively. Composite primary outcome was achieved in 44 (18.7%) participants in the intervention arm and 41 (17.9%) in the control arm [aOR: 1.09; 95% CI: 0.67, 1.77]. Mortality was documented in 34 (13.6%) and 31 (14.6%) participants in intervention and control arm, respectively [aOR) 1.06 95% CI: -0.61 to 1.83]. Interpretation: CP was not associated with reduction in mortality or progression to severe COVID-19. This trial has high generalizability and approximates real-life setting of CP therapy in settings with limited laboratory capacity. A priori measurement of neutralizing antibody titres in donors and participants may further clarify the role of CP in management of COVID-19.

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Background: Platelet Transfusion are used for the treatment and prevention of bleeding in patients with decreased number and function of platelets. Platelet for transfusion can be provided by platelet concentrates, which are obtained either by PRP or buffy coat method from whole blood or by apheresis. Platelet Recovery in a patient is influenced by the transfused dose of platelets which in turn is dependent on the platelet yield. Aim of Study: In this study, our main objective is to identify the donor parameters that influence the platelet yield obtained by apheresis. Methods: This prospective study was undertaken in the Department of IHBT.140 healthy donors were selected for plateletpheresis according to guidelines laid down by Drugs and cosmetics Act over a period of one year. The plateletpheresis procedures were performed on Haemonetics MCS plus separator. Yield predicting donor variables included in the study were Age, Gender, Haemoglobin concentration, Haematocrit and Platelet count. The relationship between predonation donor variable and yield was studied using pearson correlation. Results: The Mean platelet yield was 3.19±0.48×10 11 per unit. Mean predonation platelet count of donor was 2.77± 0.46×10 5 /µl. Mean age of the Donor was 30.31±8.14. Positive Correlation was observed between platelet yield and predonation platelet count of donor(r=0.318, P value 0.0001) which is significant. No such correlation was seen between platelet yield and Haemoglobin(r=0.131, P value 0.122), Haematocrit (r=0.058, P value 0.499), Age of Donor(r=0.034, P value 0.692). Conclusion: The possibility of obtaining higher platelet yield reduces the frequency of platelet transfusion and number of donor exposures with important consequent clinical and economic advantages.

Background: Supply of safe blood starts with healthy voluntary non remunerated blood donors. Blood donor screening and testing for TTI has become stringent all over the world. A fundamental part of preventing TTI is to notify and counsel reactive donors which help in preventing secondary transmission of infectious disease.Methods: This observational descriptive study is done to determine the number of contacted TTI reactive donors and their response rate after notification of their abnormal tests. It includes all the sero-reactive donors from July 2015 to June 2016 in the department of IHBT, GGSMCH. Blood donors who were sero-reactive for any TTI were recalled and tested again with ELISA kit of different manufacturer or lot number and by rapid card tests. Donors’ sero reactive on repeat testing were informed, counseled and referred to ICTC (for HIV) or Physician (for hepatitis B and hepatitis C). Confidentiality was maintained at every level.Results: During the study period, numbers of blood donors were 12621, out of which 343 blood donors were found to be sero-reactive. 23 donors were HIV, 230 Hepatitis C, 90 were HBsAg reactive. We could contact 182 out of 343 sero reactive donors telephonically. 161 sero-reactive did not attend blood bank phone call or their contact number was changed. Amongst the 182 contacted donors, 72 donors responded for the notification call and attended counseling.Conclusions: Response rate among reactive donors is quite low and a big challenge. This shows poor health care knowledge and social stigma regarding TTI among donors.

Background: Donor notification is emphasized as an efficient method of curtailing TTIs recently. But its limitations like low notification rate and lack of follow up of treatment of notified donors are still unaddressed. The aim of the study was to analyze the response rate of notified reactive donors, to elicit hidden risks factors and to see impact of donor notification on reactive donors.Methods: This retrospective study was conducted in the blood bank of a 350 bedded multispecialty hospital in north India. Data was collected from reactive blood donor counselling register over a period of one year. After six months a telephonic interview was conducted of all the reactive donors who responded to notification calls and came for counselling to inquire if they went for further testing and treatment after they were notified.Results: There were 1345 whole blood donations over a period of 14 months of which 29 (2.15%) were reactive donors. Notification rate was 48.27%. During counselling 4 donors revealed high risk history which they had denied during pre-donation counselling. After telephonic conversation with these notified donors, we analyzed that 7 (50%) donors were taking treatment while 3 donors informed that they got themselves tested from a private lab and were reported negative. Two donors informed that they had not gone for any testing anywhere while we could not trace 2 donors due to change of contact numbers.Conclusions: Curtailing TTI’s through donor notification by blood banks alone is an unattainable mission. A centralized computer data system connecting all blood banks and interlinking of government agencies and blood banks like the recently started NVHCP is need of the hour.