The Generative Brain

NHS Blood and Transplant (NHSBT), England

NHS Blood and Transplant is the blood service for England and one of the four UK blood services whose donor selection guidelines are set through JPAC. In the prion field it matters for vCJD blood safety: it applies the UK vCJD measures (leucodepletion since 1999, permanent deferral of donors transfused since 1980, deferral of donors at increased prion risk), co-runs the Transfusion Medicine Epidemiology Review (TMER) with the National CJD Research and Surveillance Unit, and, after the government lifted the vCJD-era ban on fractionating UK plasma, now sends recovered UK plasma for manufacture into immunoglobulin and albumin for NHS patients. An NHSBT author is on the 2023 multi-party review that judged UK plasma safe for fractionation with respect to vCJD. Information only, not medical or regulatory advice.

Key facts

  • UK vCJD blood measures listed by the Department of Health include recall of components and plasma products from donors who later develop vCJD (December 1997), leucodepletion of all transfused blood (October 1999), non-UK plasma for fractionated products (1999), and exclusion of donors transfused since January 1980 (April 2004, widened July 2004).
  • In July 2005 about 100 blood donors to three people who later developed vCJD were asked to stop donating and to tell clinicians before invasive procedures, and in November 2005 a further 50 recipients of blood from those donors were traced and notified.
  • Current JPAC whole blood guidance bars anyone transfused with blood components or treated by plasma exchange anywhere in the world since 1 January 1980, explaining the cutoff by the 2003 vCJD death of a recipient of blood from a donor later diagnosed with vCJD and by the date predating the BSE epidemic.
  • The JPAC prion entry, which the UK blood services apply, excludes donors with any prion disease and those at increased risk: familial risk, notified procedure risk, being told a recipient of their blood developed a prion disorder, dura mater or ocular grafts, pituitary extracts, and transfusion or allogeneic tissue since 1980; a 2022 change dropped the deferral for recipients of donated eggs or embryos.
  • Deceased tissue donor guidance carries the same prion exclusions, with the 1980 cutoff applied to any allogeneic human tissue received.
  • TMER traces blood donors who develop CJD forward to recipients and recipients back to donors; the 2016 update, with authors at NHSBT Cambridge and Colindale, found 18 vCJD cases who had donated, whose 67 traced recipients included 3 who developed vCJD, and no new transfusion-associated vCJD case since 2007.
  • In 2019 SaBTO withdrew plasma importation and single-donor apheresis platelets as vCJD measures and kept leucodepletion.
  • The MHRA reports that the Commission on Human Medicines found negligible added vCJD risk from UK plasma for immunoglobulins, with use conditional on leucodepletion, deferral of high-risk donors and donor to recipient traceability; a 2023 paper extended the same conclusion to albumin.
  • NHSBT announced that plasma recovered from whole blood donations could go to a fractionator for medicines for the NHS once the vCJD-linked restriction was lifted.
  • The first NHS patients received immunoglobulin made from UK-donated plasma in March 2025; by 12 September 2025, 2,221 patients had been treated and 574,402 litres of UK plasma had gone to Europe for manufacture.
  • The 2023 Vox Sanguinis review arguing that UK plasma is safe for fractionation lists an NHSBT co-author alongside the other three UK blood services, DHSC, the NCJDRSU, IPFA, PPTA and industry; it states over 40 million UK blood components issued since 1999 leucodepletion with no reported transfusion-transmitted vCJD.
  • NHSBT is on the IPFA member list, and it gave the talk on vCJD and the return of UK plasma to fractionation at the 30th IPFA/PEI workshop in May 2024.

Timeline

  1. 1997Components and plasma products from donors who later develop vCJD to be withdrawn or recalled.
  2. 1999Leucodepletion of all blood for transfusion; plasma for fractionated products sourced outside the UK from 1999.
  3. 2004Exclusion of donors transfused since January 1980, widened in July 2004.
  4. 2005About 100 donors linked to three vCJD cases notified; a further 50 recipients notified in November 2005.
  5. 2016Updated TMER results published with NHSBT co-authors.
  6. 2019SaBTO withdraws plasma importation and apheresis platelet vCJD measures, keeps leucodepletion.
  7. 2020Commission on Human Medicines concludes on 8 October that UK plasma for immunoglobulin adds negligible vCJD risk; the government lifts the ban on 25 February 2021.
  8. 2022JPAC prion entry revised to drop egg and embryo recipient deferral.
  9. 2023Thomas et al. review on UK plasma and vCJD published with an NHSBT co-author.
  10. 2023MHRA paper finds no or minimal added vCJD risk from UK plasma for albumin.
  11. 2024NHSBT talk on vCJD and UK plasma at the 30th IPFA/PEI workshop.
  12. 2025First NHS patients treated with immunoglobulin from UK plasma.
  13. 2025Six month milestone: 2,221 patients treated.
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