Transmission of Variant Creutzfeldt-Jakob Disease Through Blood Transfusion and Plasma-Derived Products: A Narrative Review of Observed and Modeled Risks

• Published in: Transfusion medicine reviews 2023-07, Vol.37 (3), p.150747-150747, Article 150747
• Main Authors: Pozzo di Borgo, Alexis, Rochette, Samuel, Gaussen, Amaury, O'Brien, Sheila F．, Germain, Marc, Renaud, Christian, Lewin, Antoine
• Format: Article
• Language: English
• Subjects: Blood Donation; Blood Donors; Blood Transfusion; Creutzfeldt-Jakob Syndrome - epidemiology; Donor deferral; Humans; Leukodepletion; Plasma-derived products; Second wave; Statistical; Transfusion; Transfusion-transmitted infections; United Kingdom - epidemiology; Variant Creutzfeldt-Jakob disease
• ISSN: 0887-7963; 1532-9496
• DOI: 10.1016/j.tmrv.2023.150747

•No case of transfusion-associated variant Creutzfeldt-Jakob disease (vCJD) has been reported since 1999.•Observed and predicted risk estimates of transfusion-acquired vCJD are low.•vCJD-related blood donation criteria no longer seem justified. Secondary transmission of variant Creutzfeldt-Jakob disease (vCJD) can occur through blood transfusion or receipt of plasma-derived products. However, published reviews on this topic are outdated, focused on a single country or product type, or did not comprehensively review modeling studies on the risk of transfusion-transmission. We reviewed existing data on observed and modeled risks of transfusion-transmission of vCJD. To date, five patients are suspected to have acquired clinical vCJD or a vCJD infection after receiving a blood or plasma-derived product from a donor who later developed clinical vCJD. All of these cases received a nonleukodepleted blood-derived product in the United Kingdom between 1994 and 1999. Thus, all transfusion-associated cases occurred before the adoption of universal leukodepletion in 1999, which supports the preferential tropism of vCJD for leukocytes. In descriptive cohort studies, no cases of clinical vCJD were observed over ∼13 years of follow-up. In modeling studies, the risk of collecting a contaminated donation was generally