Creutzfeldt-Jakob disease and blood transfusion: Results of the UK transfusion medicine epidemiological review study
Creutzfeldt-Jakob disease and blood transfusion: Results of the UK transfusion medicine epidemiological review study
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DOI：
10.1111/j.1423-0410.2006.00833.x
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发表时间：
2006-01-01
期刊：
影响因子：
2.7
通讯作者：
Will, R. G.
中科院分区：
文献类型：
--
作者：
Hewitt, P. E.;Llewelyn, C. A.;Will, R. G.
背景和目标 本文报告了截至 2006 年 3 月 1 日英国国家克雅氏病监测单位 (NCJDSU) 和英国血液服务中心 (UKBS) 正在进行的输血医学流行病学审查 (TMER) 研究的结果，以确定是否有任何证据表明克雅氏病 (CJD)，包括散发性克雅氏病 (sCJD)、家族性克雅氏病 (fCJD) 和变异型克雅氏病克雅氏病 (vCJD) 可通过输血传播。材料和方法 将有献血或输血史的散发性克雅氏病和 fCJD 病例通报给 UKBS。所有年龄 > 17 岁的 vCJD 病例均将诊断通知给 UKBS。发起对捐赠记录的搜索，并通过回溯来确定所有捐赠的去向。对于有输血史的病例，会搜索医院和 UKBS 记录来识别献血者。根据 NCJDSU 登记册检查确定的受血者和献血者的详细信息，以确定是否存在任何匹配。 结果 有献血史的克雅氏病病例：报告为献血者的 18/31 例 vCJD、3/93 sCJD 和 3/5 例 fCJD 病例被确认分别向 66、20 和 11 名受血者输注了不稳定成分。两名 vCJD 接受者已作为 vCJD 确诊病例和疑似病例出现在 NCJDSU 登记册上。后者在接受来自两个不同捐赠者的非去白细胞红细胞 (RBC) 后分别在 6.5 年和 7.8 年出现 vCJD 症状，这两个捐赠者在捐赠后约 40 个月和 21 个月出现临床症状。第三名接受者在临床症状出现前约 18 个月接受了另一位 vCJD 病例捐赠的红细胞，死后（输血后 5 年）淋巴组织中发现异常朊病毒蛋白，但没有 vCJD 临床症状。有输血史的克雅氏病病例：7/11 vCJD 和 7/52 sCJD 病例的医院记录包括分别由 125 名和 24 名捐献者捐献的不稳定血液成分的输血史。两名患有 vCJD 的接受者与已在 NCJDSU 登记册上作为 vCJD 病例出现的捐赠者有联系（见上文）。没有建立进一步的联系。 结论 本研究确定了 3 例 vCJD 感染可能通过输血传播的病例，其中包括 2 例确诊的临床病例和 1 例临床前或亚临床感染病例。迄今为止，这项研究尚未提供通过输血传播 sCJD 或 fCJD 的证据，但有关这些疾病形式的数据有限。
Background and Objectives This paper reports the results to 1 March 2006 of an ongoing UK study, the Transfusion Medicine Epidemiological Review (TMER), by the National CJD Surveillance Unit (NCJDSU) and the UK Blood Services (UKBS) to determine whether there is any evidence that Creutzfeldt-Jakob disease (CJD), including sporadic CJD (sCJD), familial CJD (fCJD), and variant CJD (vCJD) is transmissible via blood transfusion.Materials and Methods Sporadic CJD and fCJD cases with a history of blood donation or transfusion are notified to UKBS. All vCJD cases aged > 17 years are notified to UKBS on diagnosis. A search for donation records is instigated and the fate of all donations is identified by lookback. For cases with a history of blood transfusion, hospital and UKBS records are searched to identify blood donors. Details of identified recipients and donors are checked against the NCJDSU register to establish if there are any matches.Results CJD cases with donation history: 18/31 vCJD, 3/93 sCJD, and 3/5 fCJD cases reported as blood donors were confirmed to have donated labile components transfused to 66, 20, and 11 recipients respectively. Two vCJD recipients have appeared on the NCJDSU register as confirmed and probable vCJD cases. The latter developed symptoms of vCJD 6.5 years and 7.8 years respectively after receiving non-leucodepleted red blood cells (RBCs) from two different donors who developed clinical symptoms approximately 40 and 21 months after donating. A third recipient, given RBC donated by a further vCJD case approximately 18 months before onset of clinical symptoms, had abnormal prion protein in lymphoid tissue at post-mortem (5-years post-transfusion) but had no clinical symptoms of vCJD. CJD cases with history of transfusion: Hospital records for 7/11 vCJD and 7/52 sCJD cases included a history of transfusion of labile blood components donated by 125 and 24 donors respectively. Two recipients who developed vCJD were linked to donors who had already appeared on the NCJDSU register as vCJD cases (see above). No further links were established.Conclusions This study has identified three instances of probable transfusion transmission of vCJD infection, including two confirmed clinical cases and one pre- or sub-clinical infection. This study has not provided evidence, to date, of transmission of sCJD or fCJD by blood transfusion, but data on these forms of diseases are limited.