- 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
- 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
- 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 follows 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 12-18
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
- 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.