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Creutzfeldt-Jakob disease lookback study: 21 years of surveillance for transfusion transmission risk
Lauren A Crowder1, Lawrence B Schonberger2, Roger Y Dodd3
1Scientific Affairs, American Red Cross, Rockville, Maryland.
Insights
There is no evidence of Creutzfeldt-Jakob disease (CJD) transmission through blood transfusions. A long-term study tracking recipients of blood from CJD-diagnosed donors found no cases of transfusion-transmitted CJD.
Area of Science:
- Neuroscience
- Epidemiology
- Public Health
Background:
- Transfusion transmission of human prion diseases is known for variant Creutzfeldt-Jakob disease (vCJD).
- Classic forms of Creutzfeldt-Jakob disease (CJD), including sporadic, genetic, and iatrogenic types, have not been linked to transfusion transmission.
- Prions or misfolded prion proteins have been detected in the blood of some sporadic CJD patients, but no transfusion-transmitted cases have been confirmed.
Purpose of the Study:
- To assess the risk of blood-borne Creutzfeldt-Jakob disease (CJD) transmission in the United States.
- To evaluate transfusion transmission of CJD through a lookback study of blood product recipients.
Main Methods:
- The American Red Cross initiated a lookback study in 1995.
- Blood donors diagnosed with CJD were identified, and their blood product recipients were traced.
- Recipients were monitored annually using the National Death Index for subsequent CJD diagnosis.
Main Results:
- 65 CJD donors and 826 of their blood recipients were enrolled in the study.
- A total of 3934 person-years of follow-up data was collected.
- No transfusion-transmitted cases of CJD have been identified to date.
Conclusions:
- Current epidemiologic studies, including this lookback study, provide no evidence for CJD transfusion transmission.
- The risk of CJD transmission via blood transfusion is considered theoretical.
Background:
Transfusion transmission of human prion diseases has been observed for variant Creutzfeldt-Jakob disease (vCJD), but not for the classic forms of prion disease (CJD: sporadic, genetic, and iatrogenic). Although the presence of prions or misfolded prion proteins in blood has been documented in some patients with the most common form of CJD, sporadic CJD, no transfusion-transmitted cases of CJD have been recognized. Since 1995, the American Red Cross has conducted a lookback study of the recipients of blood products from donors who develop CJD to assess the risk of blood-borne CJD transmission in the United States.
Study Design And Methods:
Blood donors subsequently diagnosed with confirmed or probable CJD were enrolled and the consignees were asked to identify the recipients of their blood products. These donors' transfusion recipients are traced annually with the National Death Index to see if they subsequently die of CJD.
Results:
To date, 65 CJD donors have been enrolled along with 826 of their blood recipients. These recipients have contributed 3934 person-years of follow-up and no transfusion-transmitted cases of CJD have been recognized.
Conclusion:
From this study, as well as other epidemiologic studies, there is no evidence of CJD transfusion transmission; this risk remains theoretical.
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