Blood transfusion: The Irish Blood Transfusion Service (IBTS) has started trials on a filter system to reduce the risk of patients becoming infected with the human form of mad cow disease, vCJD, through blood transfusion.
If the trials are successful and the technology introduced, it will add €7-€10 million to the annual running costs of the IBTS. The Department of Health and the Health Service Executive have both been briefed about the technology and its cost.
IBTS medical director Dr Willie Murphy said trials of the Leukotrap Affinity Prion Reduction Filter System started three weeks ago. "We have run trials on 28 units of blood. It will take about five weeks to assess the impact of the technology on the blood.
"If there is no adverse reaction, we will start looking at clinical trials, probably involving 200 patients. That will take us until roughly the end of the year and we'll assess it then."
The technology uses a filter to remove prions thought to cause vCJD from red cells which are the most commonly transfused blood component.
The trials are to ensure that the blood remains biologically active after the filtering and that the shelf-life remains the same.
At a cost of €40-€70 per unit of blood, introducing the prion technology would be expensive, said Dr Murphy. "We don't have an exact figure on the price yet but the cost is per unit and we manufacture 130,000 units a year. It will bring the cost of a unit of blood up to about €300."
The prion technology recently received EU approval meaning it meets pan-European safety requirements for medical devices.
Concern at the possibility of vCJD being transmitted via a blood transfusion led the IBTS to ban anyone who has received blood in the State on or after January 1st, 1980 from donating.
Also banned is anyone who has spent one year or more in Britain between 1980 and 1996.
In December 2003 the British government said a patient died of vCJD after receiving blood years earlier from a donor who had contracted the disease. The British National Blood Service is also evaluating the new filter.
Dr Murphy said that while the Irish blood service had been "very aggressive" in its approach to safeguarding blood donors and recipients, the tighter restrictions on who is eligible to donate was reducing the number of potential donors.
"Since the new restrictions were introduced, our potential donor pool has shrunk by about 20 per cent."
A second impact of the technology is that when a unit of blood is passed through the prion filter there is a reduction in volume as prions are removed.
Dr Murphy also admitted that for the first time in nearly three years the service was having problems meeting demand from hospitals. "Blood is tight at the moment. For the first time in three years we have been unable to meet hospital orders."
He said the reasons for the shortage were cumulative. "Basically it is the result of the deferral of a large numbers of donors."