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Blood supplies could be halved' as donors fear results of vCJD tests

October 2, 2001 The Guardian (London) by James Meikle

Britain could lose up to half its blood supplies within the next two years because of donors' fears that they might find they have the human form of BSE.

NHS officials warn that a million of the nation's 2m volunteer blood donors might drop out with the introduction of a test for the fatal variant CJD, which is expected to become available in the near future.

They fear that huge numbers could decide they do not want to donate, since they would have to be tested for a condition which is incurable, despite some hopes for treatment on the horizon.

The national blood service, which collects 2.2m donations a year from 1.9m volunteers in England and north Wales, is preparing radical contingency plans which would lead to huge changes in the way operations are conducted and post-operative care is organised. These include the increased use of recycled blood, either donated by the patient before operations or collected during operations and then transfused back; the wider use of synthetic blood substitutes; and more use of oxygen masks for patients after operations.

NBS officials outline the scale of the impending problem in information being sent to hospital consultants and blood bank managers this week, saying: The unknown risk that vCJD may be transmissible via the blood supply is probably the largest single challenge that the blood services in the UK have had to face.'

Safety measures have already been introduced over the past three years - including the removal of white cells thought most likely to transmit vCJD and the importation of plasma from the United States - but further strategies are said to be essential to mitigate the unquantified risk.

A government advisory committee will consider later this month whether anyone who has received a transfusion should now be allowed to donate blood - a measure that might in itself lead to a 10% fall in donors, according to the latest NBS estimate. This fol lows the results of experiments in sheep which suggest that the deformed prion protein linked to vCJD can be transmitted through blood.

But now the service is anticipating the fallout from advances in detection of vCJD. A blood test is expected in about 1218 months' time, and once it has been proved reliable, potential donors are likely to be screened compulsorily before they can give blood.

Liz Reynolds, the national blood service's director of public and customer services, writing in the quarterly information sheet Blood Matters, says: Should a test for vCJD be introduced, it is possible that some donors will not wish to know the outcome. And, if it transpires that a donor knows they might have an incurable disease and not have access to life insurance, mortgages etc, the likelihood of a large scale defection in the blood donor base must be considered.

Here the scenario planning around a worst case option of 50% reduction in blood donors may become a plausible option.'

Twenty-two people have so far been identified as having received transfusions using blood from 13 donors who later exhibited vCJD, and thousands of others have received vaccines and clotting factors in which donations from those possibly contaminated volunteers were used.

None of those who received whole transfusions has been told, and there is still widespread debate on the ethics of doing so while there is no treatment or cure.

It is likely that patients who were told their donation was not needed would suspect the worst.

The NBS says any test would have to be robust and reliable' before it could be introduced. Future measures would continue to take into account the delicate balance between safety and sufficiency of supplies.

Several countries have already imposed restrictions on donors who have lived in Britain and Europe. A total of 101 Britons have died from vCJD , with six suspected victims still alive.


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