Introduction Of Leucodepletion Research Articles

Safety profile of plasma for fractionation donated in the United Kingdom, with respect to variant Creutzfeldt–Jakob disease

Plasma-derived medicinal products (PDMPs) are life-saving and life-improving therapies, but the raw material is in short supply: Europe depends on importation from countries including the United States. Plasma from donors resident in the United Kingdom has not been fractionated since 1999 when a precautionary measure was introduced in response to the outbreak of variant Creutzfeldt-Jakob disease (vCJD). Cases of vCJD have been far fewer than originally predicted in the 1990s. Since the introduction of leucodepletion in 1999, and accounting for the incubation period, more than 40 million UK-derived blood components have been issued with no reports of TT vCJD. In February 2021, the UK Government authorized manufacture of immunoglobulin from UK plasma. Following separate reviews concluding no significant difference in the risk posed, the United States, Australia, Ireland and Hong Kong also lifted their deferrals of blood donors with a history of living in the United Kingdom. Other countries are actively reviewing their position. Demand is rising for PDMPs, and Europe faces a threat of supply shortages. Industry and patient groups are clear that using UK plasma would bring significant immediate benefits to patients and to the resilience of the European supply chain. From this scientific review, we conclude that UK plasma is safe for fractionation and urge blood regulators and operators to take account of this safety profile when considering fractionation of UK plasma, and to revise their guidelines on the deferral of donors who have lived in, or received a transfusion in, the United Kingdom.

A survey of blood transfusion practice in UK cardiac surgery units

Blood is expensive and carries risks. The theoretical risk of variant Creutzfeldt-Jakob disease and the consequent introduction of leucodepletion by UK blood services has significantly increased the cost of blood to the National Health Service. This is with a probable increase in demand because of waiting lists and no concurrent increase in donations. Cardiac surgery is a major user of blood. The use of guidelines and blood conservation techniques such as perioperative cell salvage may result in a reduction in blood use [1]. We do not have guidelines in our unit and have reviewed our blood use over the past 3 years. In the absence of good evidence from which to construct guidelines, we have surveyed UK cardiac surgery units on blood use and the presence of audit and guidelines in order to form an overview of current practice.