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Dealing with the uncertain risk of variant C reutzfeldt‐ J akob disease transmission by coagulation replacement products
Author(s) -
Millar Carolyn M.,
Makris Mike
Publication year - 2012
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2012.09201.x
Subject(s) - coagulation , subclinical infection , transmission (telecommunications) , medicine , risk factor , disease , factor ix , coagulation disorder , immunology , electrical engineering , engineering
Summary The identification of variant Creutzfeldt‐Jakob disease (v CJD ) in the UK in 1996 led to significant concerns about the possibility of secondary transmission, however the prevalence of subclinical v CJD and risks of v CJD transmission by plasma are not known. In the UK , public health precautions have been implemented in all recipients of coagulation factor concentrates manufactured from UK plasma pools between 1980 and 2001. The recent demonstration of abnormal prion protein in a spleen sample at autopsy of a UK haemophilic patient who received coagulation factor concentrates to which a donor incubating v CJD had contributed most likely represents the first case of v CJD transmission by coagulation factor concentrates. We review the uncertainties that surround risk of v CJD transmission by coagulation factor concentrates, the challenges in dealing with undefined risks, the rationale behind current policies and the implementation of v CJD surveillance and risk management measures in bleeding disorder patients in the UK .