Thomas Stephen, Roberts Barnaby, Domanović Dragoslav, Kramer Koen, Klochkov Denis, Sivasubramaniyam Sujan, Miloslavich Dana, Plançon Jean-Philippe, Rossi Françoise, Misztela Dominika, Kirkpatrick Lauren, Miflin Gail, Birchall Janet, McLintock Lorna, Knight Richard
Joint UK Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee, London, UK.
Department of Health and Social Care, London, UK.
Vox Sang. 2023 May;118(5):345-353. doi: 10.1111/vox.13416. Epub 2023 Mar 7.
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.
血浆衍生药物产品(PDMPs)是挽救生命和改善生活的疗法,但原材料供应短缺:欧洲依赖从包括美国在内的国家进口。自1999年为应对变异型克雅氏病(vCJD)爆发而采取预防措施以来,居住在英国的献血者的血浆就没有进行过分离。vCJD病例比20世纪90年代最初预测的要少得多。自1999年引入白细胞去除术以来,并考虑到潜伏期,已发放了超过4000万份来自英国的血液成分,没有TT vCJD的报告。2021年2月,英国政府批准用英国血浆生产免疫球蛋白。在分别进行的审查得出风险无显著差异的结论后,美国、澳大利亚、爱尔兰和香港也取消了对有在英国居住史的献血者的延期献血限制。其他国家也在积极审查其立场。对PDMPs的需求在上升,欧洲面临供应短缺的威胁。行业和患者团体明确表示,使用英国血浆将给患者和欧洲供应链的韧性带来显著的直接好处。从这项科学审查中,我们得出结论,英国血浆用于分离是安全的,并敦促血液监管机构和运营商在考虑对英国血浆进行分离时考虑到这一安全情况,并修订其关于对在英国居住过或接受过输血的献血者延期献血的指导方针。