General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsEbola-Could Blood Transfusion extend life?
Can someone knowledgeable answer this question:
Could one or more blood transfusions of non-ebola-antigen blood (regular blood) help an Ebola patient if they are given the transfusions early in the infection process?
My thought is, since Ebola attacks and replicates in the blood vessels, perhaps blood transfusions might be useful for simply flushing out some of the virus in order to keep the viral load at as low a level as possible until the patient could get access to a better treatment (Zmapp, antigen blood, ventilation, etc).
Egnever
(21,506 posts)My understanding is that it isnt the virus that kills you it is your immune systems over reaction to the virus that does you in.
I don't think that a blood transfusion will change anything in that scenario.
JimDandy
(7,318 posts)have less material to react to, though?
Thanks for helping me think this through.
MrMickeysMom
(20,453 posts)...your own immunity seems to be the largest factor.
Nova did a great program last evening on Ebola and the unfolding methods of associated with gaining control over the virus.
JimDandy
(7,318 posts)I having been reading a lot today about the use of Ebola-antigen blood transfusions to save lives and the problems with getting an uncontaminated antigen blood supply up and going in West Africa.
So my thought was, what if they use the ready-to-go blood (already tested for HIV, hepatitis, etc.) in blood banks to keep patients in a holding pattern until a safe antigen blood supply is ready.
sharp_stick
(14,400 posts)the body doesn't have time to respond to the infection. Just adding more won't help the immune response. And the virus isn't just in the large vessels, don't forget all those capillaries, just flushing the system would never get it cleared out.
JimDandy
(7,318 posts)by doing that until a safe antigen containing blood supply is operating in West Africa, then..none?
sharp_stick
(14,400 posts)a full on transfusion is a real shock to the system even in a relatively healthy individual, an educated guess would have it doing nothing good.
JimDandy
(7,318 posts)woodsprite
(11,914 posts)That causes the internal bleeding, bruising with Ebola.
Her DIC was probably due to complications from diabetes,
but the last 3 weeks of her life she was on platelet transfusions
to counter the DIC. Since they couldn't fix the underlying
problem the platelet transfusions and the fact they inserted
screens to filter the blood clots were keeping her alive.
We were told that even if we continued the transfusions,
that eventually her organs would fail. She died a couple
of days after stopping the transfusions.
Soooo, speaking from that experience, I'd say it might work
for a matter of weeks, maybe longer, but if you couldn't fix
the underlying problem, it would be for nothing.
JimDandy
(7,318 posts)So sorry about your mom woodsprite.
Thanks for your input.
woodsprite
(11,914 posts)with doctors, they said people can recover from DIC,
it's just that they had to find out and treat the underlying cause.
The degradation of the organs can be a factor as well.
magical thyme
(14,881 posts)so no, even draining out and replacing all your blood wouldn't work because the virus will still be replicating in that third group of cells.
Macrophages are monocytes that have moved into tissue to provide protection throughout your body.
After the virions bud out, they infect the endothelial cells that line the blood vessels, which starts the DIC and damages their structure, so they start leaking blood components. Eventually, the DIC causes you to run out of platelets and possibly coagulation factors as well, so the clotting stops but then you are susceptible to hemorrhage. As your vessels become leakier and you lose more blood components and blood, plus lose fluids to vomiting and diarrhea, your blood pressure drops and your heart can't pump enough blood. You go into hypovolemic shock and organs begin to fail.
JimDandy
(7,318 posts)What % viral load is in each of those groups at the beginning of the infection? For example, let's say the 2 types of cells in the blood group contain 90% of the viral load up through the first week and the macrophages in the tissue group have only 10%. If something like that is the case, then would replacing the patient's entire blood volume at the end of the first week put the patient back at 10% viral load in their body and restart the clock at that level of infection?
I have no medical background and apologize if this question sounds inane from a medical standpoint.
Eta-if it could help at all, then people in the rest of the world could go down to their local blood banks, get a massive stock-pile going, and start air freighting it in to West Africa to keep everyone alive while WHO and other health experts work to get the antigen blood supply in place locally. Sort of a world-wide division of labor.
magical thyme
(14,881 posts)reproducing, but you have no clinical symptoms and tests would come back negative. By the time you show symptoms, millions of virions have already budded out and started infecting the endothelial cells. So it's already too late for pre-emptive replacement.
They do use transfusions as part of the therapy, but it's too late to reduce infection.
JimDandy
(7,318 posts)Aerows
(39,961 posts)We won't have answers until there are trials.
Yo_Mama
(8,303 posts)The virus is replicating in the cells. Draining the patient's blood and just replacing it with new would be not change much about the disease course, because the patient's body has to manufacture the antibodies, and that occurs in the patient's own blood system. It could make it worse, because the signalling process would be at least somewhat muted.
Using WBCs from patients who have recovered from Ebola directly helps because there you are giving the patient extra antibodies that the patient's own body is struggling to mass-produce. So you are giving more ammo. You do have to have a blood type match, though, because you are transfusing the antibodies, and if the antibodies transfused are going to attack the patient's cells, you are not going to make the patient better.
Some basic info on immune response:
http://www.nlm.nih.gov/medlineplus/ency/article/000821.htm
Other things that might hurt a patient early in the disease course would be inflammation inhibitors such as ibuprofen, because inflammation is part of the immune response. Some suspect that flesh-destroying bacterial infections are promoted by anti-inflammatories such as ibuprofen.
http://www.whale.to/drugs/nurofen.html
Dropping fever and inflammation early in acute viral infections is generally not a good idea. The misery one feels is produced by the body's innate protective response.
JimDandy
(7,318 posts)I was hoping if we just assume every doctor and health care worker in the Ebola fight in West Africa WILL contract the disease, then just give them a transfusion at the end of each work day to keep the viral load low. It does sound stupid now after reading your info and it was so kind of your to respond anyway.
Avalux
(35,015 posts)As others have stated in this this thread, it's the body's own immune system that over-reacts to the virus, which will eventually lead to septic shock and death.
However - the WHO is recommending blood transfusions from convalescent patients, and are in the process of developing a donation program where this will be available to newly infected patients. We know that this is at least something that may help in the absence of drug treatment.
JimDandy
(7,318 posts)the only ticket back to life at this time, so I hope they ramp it up quickly. Thanks Avalux.
Avalux
(35,015 posts)Let me add - it's not whole blood; they spin it in a centrifuge to remove the red blood cells; what you're left with is the yellow plasma that contains the antibodies. This is what they give to patients.
JimDandy
(7,318 posts)called it blood serum. Just looked up the difference between serum and plasma...serum is watery with no clotting factor. Clotting is a problem with Ebola patients, so that may be why the article specified serum instead of plasma. I find this all very intetesting...and very sad...to have to be learning about.
mucifer
(23,542 posts)Research MDs are working on the cure and management of the disease. They have been for over a decade.
Something as simple as blood transfusions is not the answer.
They are doing research on people in Africa who had the disease many years ago, but got better without meds. That hopefully is giving them more answers.
JimDandy
(7,318 posts)is a sufficent therapy then. Thanks so much for your reply.
JimDandy
(7,318 posts)It appears this is not a good idea, so I'll drop it.