Joint UK Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee (JPAC)

Key facts

• JPAC has two jobs: advising the four UK blood and tissue services and writing detailed guidelines for them; a service may depart from a guideline only with a documented justification.
• NHS Blood and Transplant hosts JPAC and the four services fund it jointly.
• Under terms of reference updated in April 2025, a JPAC Board that meets three times a year reports to the UK Forum. The Board includes the medical directors of the four services and representatives of the MHRA, the MHRA South Mimms Laboratories (formerly NIBSC), the Human Tissue Authority and the UK quality managers group, with lay members; the Irish Blood Transfusion Service and SHOT attend as observers.
• Work is done by seven Standing Advisory Committees, covering blood components, care and selection of donors, cellular therapy products, immunohaematology, information technology, tissues, and transfusion transmitted infection, with a parasitology and blood safety subcommittee; their chairs sit on an Executive Working Group that meets six times a year.
• The JPAC Office includes a head of scientific safety policy whose post spans both JPAC and SaBTO.
• JPAC describes SaBTO as a DHSC committee advising ministers in all four UK countries on the safety of blood, cells, tissues and organs, and says much of SaBTO's evidence comes from blood service staff and the JPAC transfusion transmitted infection committee.
• Blood services operate under the Blood Safety and Quality Regulations 2005, with the MHRA as competent authority; tissue services operate under the 2007 tissue quality and safety regulations, with the Human Tissue Authority as competent authority.
• JPAC publishes separate donor selection guidelines for whole blood and components, deceased and live tissue donors, bone marrow and peripheral blood stem cells, and cord blood, plus a Geographical Disease Risk Index and the Red Book (Guidelines for the Blood Transfusion and Tissue Transplantation Services in the UK).
• The whole blood prion entry bars donors with any form of CJD or other human prion disease and those at increased risk: two or more affected blood relatives or genetic counselling advice of risk, notified risk from a procedure, notification that a recipient of their blood or tissue developed a prion disorder, dura mater or ocular tissue grafts, human pituitary extracts, and transfusion or allogeneic tissue since 1 January 1980.
• A person with two or more affected relatives may be accepted if genetic counselling has found them not at risk, subject to confirmation by a Designated Clinical Support Officer; this clause appears in the blood, deceased tissue, bone marrow and cord blood entries, and in the cord blood entry it is written for the mother.
• The bone marrow and cord blood prion entries, last changed in January 2016, apply the same exclusions, including any allogeneic human tissue since 1980, citing concern that tissue or organ recipients could add to a possible second wave of vCJD as transfused donors might.
• The whole blood transfusion entry excludes anyone who has received, or may have received, red cells, platelets, plasma, cryoprecipitate, granulocytes, human normal immunoglobulin or plasma exchange anywhere in the world since 1 January 1980.
• JPAC gives the rationale for the 1980 cutoff as the autumn 2003 vCJD death of a UK recipient of blood from a donor who later developed vCJD, further prion infections in such recipients, and the fact that 1980 predates the period when BSE, the presumed cause of vCJD, was prevalent; the entry follows SaBTO and its predecessor committee.
• The whole blood prion entry notes that UK use of pituitary-derived gonadotrophin and growth hormone had stopped by 1986 and use of dura mater by 1993.
• In November 2024, according to a search excerpt of the JPAC Board minutes, a CJD Review Group recommended keeping the 1980 transfusion deferral but changing its rationale from vCJD to possible amyloid-beta transmission, and noted that SaBTO and DHSC would coordinate with the MHRA because of possible effects on approval of UK plasma for fractionation.
• The first author of the 2023 Vox Sanguinis review arguing that UK plasma is safe to fractionate with respect to vCJD is listed with a JPAC affiliation, alongside authors from the four UK blood services and the National CJD Research and Surveillance Unit.

Timeline

1. 2016Bone marrow and cord blood prion entries revised to exclude recipients of allogeneic tissue since 1980, in line with MSBTO advice.
2. 2018Deceased tissue donor prion entry revised to comply with MSBTO advice.
3. 2022Whole blood prion entry revised to drop the deferral for recipients of donated eggs or embryos, following SaBTO microbiological safety guidance.
4. 2023Review on the vCJD safety of UK plasma for fractionation published with a JPAC-affiliated first author.
5. 2024JPAC Board minutes record a CJD Review Group recommendation to keep the 1980 transfusion deferral with an amyloid-beta rationale (search excerpt).
6. 2025Whole blood transfusion entry updated with hepatitis C testing advice for deferred donors after the Infected Blood Inquiry; the 1980 vCJD deferral itself unchanged.
7. 2025Terms of reference updated, listing seven Standing Advisory Committees.
8. 2025Position statement on the relationship between JPAC and SaBTO posted (contents not read).
9. 2026JPAC vCJD position statement updated (contents not read).