The success of precaution? Managing the risk of transfusion transmission of variant Creutzfeldt‐Jakob disease

Wilson, Kumanan; Ricketts, Maura

doi:10.1111/j.1537-2995.2004.04116.x

Cited by 31 publications

(26 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, animal studies have shown that the current generation of leucocyte reduction filters may not be fully effective in preventing vCJD transmission, removing only about 40% of the total human transmissible spongiform encephalopathy (TSE) infectivity in endogenously infected blood (Gregori et al, 2004). As the primary vCJD outbreak declines, secondary transmission via transfusion becomes an increasingly important factor in determining the extent and duration of the overall UK epidemic (Ghani et al, 2003;Wilson & Ricketts, 2004;Garske & Ghani, 2010).…”

mentioning

confidence: 99%

Transfusion of prion‐filtered red cells does not increase the rate of alloimmunization or transfusion reactions in patients: results of the UK trial of prion‐filtered versus standard red cells in surgical patients (PRISM A)

et al. 2013

View full text Add to dashboard Cite

SummaryThis study, conducted for the UK Blood Transfusion Services (UKBTS), evaluated the clinical safety of red cells filtered through a CE-marked prion removal filter (P-Capt). Patients requiring blood transfusion for elective procedures in nine UK hospitals were entered into a non-randomized open trial to assess development of red cell antibodies to standard red cell (RCC) or prion-filtered red cell concentrates (PF-RCC) at eight weeks and six months post-transfusion. Patients who received at least 1 unit of PF-RCC were compared with a control cohort given RCC only. About 917 PF-RCC and 1336 RCC units were transfused into 299 and 291 patients respectively. Twenty-six new red cell antibodies were detected post-transfusion in 10 patients in each arm, an overall alloimmunization rate of 4Á4%. Neither the treatment arm [odds ratio (OR) 0Á93, 95% confidence interval (CI) 0Á3, 2Á5] nor number of units transfused (OR 0Á95, 95% CI 0Á8, 1Á1) had a significant effect on the proportion of patients who developed new alloantibodies. No pan-reactive antibodies or antibodies specifically against PF-RCC were detected. There was no difference in transfusion reactions between arms, and no novel transfusion-related adverse events clearly attributable to PF-RCC were seen. These data suggest that prion filtration of red cells does not reduce overall transfusion safety. This finding requires confirmation in large populations of transfused patients.

show abstract

mentioning

confidence: 99%

Transfusion of prion‐filtered red cells does not increase the rate of alloimmunization or transfusion reactions in patients: results of the UK trial of prion‐filtered versus standard red cells in surgical patients (PRISM A)

et al. 2013

View full text Add to dashboard Cite

show abstract

“…If precautionary recall of factor VIII had been fully implemented in 1986, it is clear that hundreds of cases of HIV may have been averted, and the geographic extent of human infection limited. Currently the costs and effectiveness of the "precautionary principle" in commerce are under discussion [20]. Accurate and complete description of these two global emergent diseases (through mathematical modeling and other research) will be important in informing those discussions.…”

Section: Resultsmentioning

confidence: 99%

Trade related infections: farther, faster, quieter

2005

View full text Add to dashboard Cite

Modern global trading traffics large volumes of diverse products rapidly to a broad geographic area of the world. When emergent infections enter this system in traded products their transmission is amplified. With truly novel emergent infections with long incubation periods, such as Human Immunodeficiency Virus (HIV) or variant Creutzfeld Jacob Disease (vCJD), this transmission may silently disseminate infection to far distant populations prior to detection. We describe the chronology of two such "stealth infections," vCJD and HIV, and the production, processing, and distribution changes that coincided with their emergence. The concept of "vector products" is introduced. A brief case study of HIV incursion in Japan is presented in illustration. Careful "multisectoral" analysis of such events can suggest ecologically critical pathways of emergence for further research. Such analyses emphasize the urgency of implementing safety measures when pathogens enter globally traded products.

show abstract

“…These policies have been modified as further evidence has accumulated of the prevalence of BSE and donor deferral policies have been instituted for individuals who have resided in France and all of Western Europe. Most significantly, scientific evidence has accumulated which validates the institution of the precautionary policies, both from animal models demonstrating transfusion transmission and from case reports of transfusion transmission in humans (Wilson & Ricketts, 2004).…”

Section: The Vcjd Policy Problemmentioning

confidence: 98%

Variant Creutzfeldt–Jakob disease and the Canadian blood system after the tainted blood tragedy

Wilson

Graham

Ricketts

et al. 2007

Social Science & Medicine

Self Cite

View full text Add to dashboard Cite

The transfusion transmission of hepatitis C and HIV to thousands of Canadian blood recipients was one of this country's largest public health catastrophes. In response to this crisis, and in an effort to prevent such a tragedy from occurring again, the Canadian blood system has undergone substantial reform. Variant Creutzfeldt-Jakob (vCJD) disease was the first infectious threat faced by the blood system since undergoing reform. The response at the time to this risk provides insights into the Canadian blood system's new approach to infectious threats. Our analysis of the decision-making concerning vCJD identifies two dominant themes characterizing the new blood system's approach to safety: (1) the adoption of a precautionary approach to new risks which involves taking action in advance of definitive evidence, and (2) risk aversion amongst policy makers, which has contributed to the adoption of safety measures with comparatively high cost-effectiveness ratios. Overall the principles governing the new blood system have contributed to the system both providing protection against emerging infectious risks and regaining the confidence of the public and recipients. However, the current set of policy factors will likely contribute to increasingly risk-averse policy making that will contribute to continued increases in the cost of the blood system. The challenge the blood system now faces is to find the appropriate balance between maximizing safety and ensuring the system remains affordable.

show abstract

The success of precaution? Managing the risk of transfusion transmission of variant Creutzfeldt‐Jakob disease

Cited by 31 publications

References 14 publications

Transfusion of prion‐filtered red cells does not increase the rate of alloimmunization or transfusion reactions in patients: results of the UK trial of prion‐filtered versus standard red cells in surgical patients (PRISM A)

Transfusion of prion‐filtered red cells does not increase the rate of alloimmunization or transfusion reactions in patients: results of the UK trial of prion‐filtered versus standard red cells in surgical patients (PRISM A)

Trade related infections: farther, faster, quieter

Variant Creutzfeldt–Jakob disease and the Canadian blood system after the tainted blood tragedy

Contact Info

Product

Resources

About