Special Article Challenges in Establishing a Coronavirus Disease 2019 (COVID-19) Convalescent Plasma Donation Program in a Multicultural Environment Manuel Algora, MD; Tori Mehmood, RN; Debrina L. Madison, MSN, MBA, RN; Jawahir AlAmeri, MD; Mohamed Abuzakouk, MD; Mylka Tagamtam, MLT; Lorlin Acena, MTL; Gerard Totaan, MLT; Gloria Grabski, MLT-SBB; Naima Oumeziane, MD; Pritesh Rajani, MD; Lynzi Taylor, MHA; Jorge Guzman, MD; Laila Osama AbdelWareth, MD  Context.—In the face of the coronavirus disease 2019 (COVID-19) pandemic response, it was worthwhile to test the safety and efficacy of COVID-19 convalescent plasma (CCP) transfusion. Objective.—To establish a CCP donation program based on the availability of recovered COVID-19 patients and the practical limitations in recruiting clinically valid donors in a multicultural setting. Design.—From March to June 2020, we developed a program for collection of COVID-19 CCP as part of the treatment options for patients affected with COVID-19. From an initial population of 3746 candidates, only those with positive polymerase chain reaction results in at least 2 separate tests were considered. This filter reduced the eligible donor pool to 488 patients. After other exclusions were applied, such as language barrier, age, accessibility to donation, and comorbidities, the final count was 267 potentially eligible donors, which represented only 54.7% (267 of 488) of preselected candidates. Results.—Eighty donors were called. Approximately a third of the calls provided additional challenges as outlined by the following 4 reasons: limited functional understand- ing of English; schedule availability due to rotating work timetables; transportation restrictions since public trans- port services were severely restricted during lockdown; and lost to follow-up. Finally, a total of 38 valid donors participated, upon whom 45 apheresis procedures were performed. Conclusions.—As a summary of our experience, we can conclude that despite the limitations we were able to establish an effective program. A total of 90 units of CCP were collected before the pandemic curve began to flatten toward the end of June 2020. (Arch Pathol Lab Med. 2021;145:1479–1484; doi: 10.5858/arpa.2021-0198-SA) D uring the past century, serum therapies were used successfully to treat many infectious diseases, a majority of which were stopped with the arrival of antibiotics; however, in current practice, specific immuno- globulins derived from humans and animals are important therapies for a variety of conditions (eg, parvovirus infection, cytomegalovirus infection, hepatitis A and B, rabies, botulism poisoning). In the modern era, there are also several precedents for the use of convalescent plasma (CP) from recovered patients with viral infections, such as the Spanish flu of 1918, 1,2 Argentine hemorrhagic fever, 3 and the 2009 influenza A H1N1 4 pandemic. More recently in 2014, CP from patients recovered from Ebola virus disease was recommended by the World Health Organization as an empirical treatment during outbreaks, 5 and a protocol was established for the use of CP in the treatment of Middle East respiratory syndrome coronavirus (MERS-CoV) in 2015. 6 During the initial outbreak of coronavirus disease 2019 (COVID-19), owing to the absence of available vaccines for severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2), large populations of susceptible people were affected and became ill. Management was mainly focused on infection prevention, detection, monitoring, and sup- portive care, since no specific anti–SARS-CoV-2 treatment had been recommended owing to the absence of evidence. 7 In the face of the pandemic response, it was advisable to look for other therapeutic interventions; thus, it was worthwhile to test the safety and efficacy of COVID-19 convalescent plasma (CCP) transfusion therapy in SARS- CoV-2–infected patients. Accepted for publication August 9, 2021. Published online August 18, 2021. From Pathology and Laboratory Institute (Algora), Clinical Data Abstractor Department (Mehmood, Madison), Medical Subspecial- ties Institute (AlAmeri), Allergy and Immunology Institute (Abuza- kouk), Pathology and Laboratory Institute (AbdelWareth), Executive Administration Office (Guzman), and Data Resources Management (Taylor), Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates; National Reference Laboratory, Abu Dhabi, United Arab Emirates (Algora, Tagamtam, Acena, Totaan, Grabski, AbdelWareth); Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio (Algora); College of Medicine & Health Sciences, Department of Pathology, Khalifa University, Abu Dhabi, United Arab Emirates (Algora, AbdelWareth); and SEHA-Abu Dhabi Blood Bank, Abu Dhabi, United Arab Emirates (Oumeziane, Rajani). The authors have no relevant financial interest in the products or companies described in this article. Correspondence: Manuel Algora, MD, Cleveland Clinic Abu Dhabi, Pathology and Laboratory Institute, PO Box 112412, Abu Dhabi, United Arab Emirates (email: algoram@clevelandclinicabudhabi.ae). Arch Pathol Lab Med—Vol 145, December 2021 Convalescent Plasma Donation Program—Algora et al 1479