The Generative Brain

Etablissement Francais du Sang (French national blood service)

The Etablissement Francais du Sang (EFS) is the French public blood service, created on 1 January 2000 under a 1998 health safety law as the successor to the Agence francaise du sang, which France set up in 1993 after the contaminated blood affair. It runs donor selection, collection, testing and supply of blood products, with close to 10,000 staff and 13 regional establishments. For prion disease it matters in two ways. First, its donor interviews apply the French permanent exclusions linked to prions, including a cumulative stay of more than one year in the UK between 1980 and 1996, which France kept in 2025 while some other countries dropped similar rules. Second, its TransDiag laboratory in Montpellier has been one of the main European groups building blood and surface tests for variant CJD prions, including the 2016 plasma amplification test that detected infection in two blood donors before symptoms. Information only, not medical or donation advice.

Key facts

  • The EFS was created on 1 January 2000 under the law of 1 July 1998 on health monitoring and safety; its predecessor, the Agence francaise du sang, dates from the health safety law of 4 January 1993, a response to the contaminated blood affair that gave France a single national public transfusion system under state oversight.
  • The EFS describes itself as the French public blood service with close to 10,000 staff, 13 regional establishments and activities across collection, diagnostics, blood and tissue products, care centres, research and bioproduction; its research arm reports 180 research staff in 18 teams, and its research page does not mention prions.
  • Under the ministerial order of 11 January 2022, permanent donor exclusions in France linked to non-detectable agents such as the prion include a cumulative UK stay of more than one year between 1980 and 1996, growth hormone treatment before 1989, a family history of prion disease, a cornea or dura mater graft, and brain or eye surgery before April 2001; past transfusion is also a permanent exclusion, and EFS doctors or nurses check these in a pre-donation interview.
  • The UK stay exclusion was announced by French ministers on 19 December 2000 as a maximum precaution, even though the expert group convened by the medicines agency had found blood transmission of the prion unproven in humans at that time and a majority judged a six month threshold disproportionate.
  • A February 2025 journal report on new High Council for Public Health opinions says the UK stay exclusion was kept because of uncertainty about the variant CJD epidemic and about prion-like neurodegenerative diseases, pending new ECDC recommendations.
  • In 2010 EFS Alsace reported a feasibility trial of a plasma PrPTSE screening assay on 20,000 donor samples, out of a planned 60,000 across three regional sites: specificity reached 99.90 percent after repeat testing, with 20 repeat-reactive samples judged unlikely to be true infections, and the authors said routine use would need automation.
  • The TransDiag laboratory (Transfusion Safety and Diagnostic Innovation) at EFS Pyrenees-Mediterranee in Montpellier published plasminogen bead capture with PMCA in 2013, detecting prions in preclinical scrapie sheep blood and in vCJD-spiked human plasma with 100 percent specificity on 96 blinded human plasma samples.
  • The same laboratory, with the Paris Brain Institute, the French surveillance network, INRA and the Edinburgh unit, published the 2016 plasma test that identified all 18 clinical vCJD patients among 256 plasma samples and detected prions in two donors 1.3 and 2.6 years before onset; in 2018 it moved the method to spinal fluid.
  • TransDiag also built Surf-PMCA, a test for vCJD prions on steel surfaces (2016), and showed in 2020 with ANSM funding that it agrees with infectivity in mice and that several commercial decontamination reagents fail against vCJD prions.
  • EFS TransDiag was a partner in the ANR project UnmaskingBloodPrions (December 2015, 36 months, 655,720 euro) coordinated by the CEA prion unit with the Paris Brain Institute, Hospices Civils de Lyon and INRA Toulouse.
  • EFS Montpellier co-authored a 2024 Roslin-led comparison of three blood assays in preclinical sheep, and EFS authors from Montpellier and La Plaine-Saint-Denis co-signed the 2024 European Blood Alliance consensus that judged transfusion vCJD risk from UK-linked donors minimal and named no screening test.
  • The newest EFS Montpellier paper found, from August 2026, applies the same amplification method to tau rather than to blood prions.

Timeline

  1. 1993Health safety law creates the Agence francaise du sang, predecessor of the EFS.
  2. 1998Law on health monitoring and safety provides for the EFS.
  3. 2000The EFS is created.
  4. 2000Ministers announce the exclusion of donors with a cumulative UK stay of at least one year between 1980 and 1996.
  5. 2009ISBT working party report on TSE and transfusion safety, corresponding author at EFS Montpellier.
  6. 2010EFS Alsace publishes the first 20,000 samples of a plasma prion screening feasibility study.
  7. 2013TransDiag publishes plasminogen capture with amplification for blood prions.
  8. 2015ANR UnmaskingBloodPrions starts with EFS TransDiag as a partner.
  9. 2016TransDiag publishes Surf-PMCA for prions on steel surfaces.
  10. 2016Plasma amplification test for variant CJD published in Science Translational Medicine.
  11. 2018Spinal fluid version published in Emerging Infectious Diseases.
  12. 2020Decontamination study funded by ANSM published in mSphere.
  13. 2021Paper on amplifying sporadic CJD prions, seed and substrate dependent.
  14. 2022Ministerial order sets the current donor contraindications, keeping the prion-related exclusions.
  15. 2024European Blood Alliance consensus on transfusion transmitted vCJD published with EFS co-authors.
  16. 2025Journal report says France keeps the UK stay exclusion after new HCSP opinions.
  17. 2025Sante publique France page, updated, still lists the UK stay exclusion.
  18. 2026TransDiag publishes tau amplification work.
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