Abstracts of the XXIV Annual Scientific Meeting of the British Blood Transfusion Society. September 21-23, 2006. Bournemouth, United Kingdom

Introduction Hundreds of thousands of patients in Europe undergo therapeutic human allograft treatments. There have been three recent reports of possible transmission of vCJD or of abnormal prion by blood transfusion. There is no validated blood test for vCJD, but there are techniques using tissues, that have been used in vCJD epidemiological studies. The principle of testing tonsil, spleen or other reticulo‐endothelial or neurological tissues deserves discussion including issues of test validation, logistics of biopsy sampling, timeframes, potential implications for other human material procurement and ethical issues. Method The advantages and disadvantages of instituting vCJD tests on deceased donors was considered, legal advice sought and logistical issues considered. The advantages of undertaking vCJD testing of tonsil (i) Possibility of identifying potential vCJD deceased donors in the late latent phase of vCJD infection; and (ii) UK legal precedence suggests that the public is legitimately entitled to expect that blood, and presumably tissues, are 100% safe. Disadvantages to testing (i) Unknown time when in the pre‐clinical phase abnormal PrP may be detectable; (ii) The sensitivity of tests may be less than required; (iii) The impact of false positive and false negative results (iv) Logistical aspects of testing to GMP standards; (v) Impact of laboratory turnaround time for any PrP test on tissues/organs requiring rapid release; (vi) Possible pre‐disposition to vCJD disease impact on counselling donor families; (vii) Implications for lookback on recipients an infected tissue donor where previous donations may have been given, either of blood or tissues; (viii) Risk of contamination of tissues or processing laboratories from biopsies; (ix) Loss of categories of tissue donors due to unwillingness of donor families to consent to testing; and (x) Loss of tissue donors from living donor programmes where tonsil testing could not be undertaken. Results It was concluded that tonsil and splenic biopsies should be investigated logistically to provide analytes for vCJD testing. Conclusion Multidisciplinary work is underway to take forward vCJD testing of deceased donors.