There is a high probability that vCJD can be transmitted via blood transfusion, with a number of likely cases having been described (see references below). There remains therefore a theoretical possibility that tissue grafts could also be vectors of infection. To this end Tissue Services has introduced and is evaluating a number of steps to reduce or mitigate risk. These are as follows:
Wherever possible, disposable instruments are used in the retrieval of tissues and all subsequent processing within the tissue bank. Where this is not possible advice has been taken on the appropriate washing and sterilisation procedures to minimise risks from prions.
Tissue Services is currently undertaking a feasibility study for the removal and testing of spleen tissue from deceased donors. There is evidence that vCJD prions become detectable in spleen and other lymphoid tissues before clinical onset of disease.
Tissue Services is the only tissue bank in the UK to undertake spleen testing for vCJD of donors. Use of other lymph reticular and ocular tissues as analytes for testing is under consideration.
Blood Removal from Tissues
Tissue Services has been in the vanguard of research to remove blood and marrow from bone grafts thereby reducing the risk of prion transmission.
|Evaluation of NaOH treatment of human dura mater implants to obviate Creutzfeldt-Jakob Disease transmission||J N Kearney, C Johnson||Biomaterials 12: 431-432||1991|
|Processing of whole femoral head allografts: A method for improving clinical efficacy and safety||R Lomas, O DrummondJ N Kearney||Cell and Tissue Banking 1: 193-200||2000|
|Possible transmission of variant Creutzfeldt-Jakob disease by blood transfusion||C A Llewelyn, P E Hewitt, R S G Knight, K Amar, S Clousens, J Mackenzie, R G Will||Lancet 363: 417-421||2004|
|Preclinical vCJD after blood transfusion in a PRNP codon 129 heterozygous patient||A H Peden, M W Head, D L Ritchie, J E Bell, J W Ironside||Lancet 364: 527-529||2004|
|Health Protection Agency New case of transfusion-associated variant-CJD||CDR weekly||2006:16|
|Should Deceased Donors be Tested for vCJD?||R M Warwick, R Eglin||Cell and Tissue Banking 6 (4): 263 - 270||2005|
|Creutzfeldt-Jakob disease and blood transfusion: results of the UK Transfusion Medicine Epidemiological Review study.|
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