Blood donated by women who have hadmultiple pregnancies is not to be restricted contrary to a national newspaper report earlier this month.
The Times had claimed that the National Blood Service was considering a ban on donations from mothers because they may carry an antibody linked to a serious lung condition which could prove fatal to the transfusion recipient.
However a spokesperson from the NBS told pH7 that whilst blood safety was one of its primary concerns, it currently had "no intention of banning the transfusion of blood from women who have had multiple births" - primarily because steps had already been undertaken which rendered such a move unnecessary: "The NBS already remove white blood cells from donated blood and that is where it is believed that the infection is located."
Transfusion-Related Acute Lung Injury (TRALI) is thought to have caused at least four deaths in the UK since 1998. The condition is believed to be caused by antibodies carried in the blood of some women who have had children. The antibodies can arise if an expectant mother is exposed to foetal white blood cells either through a leak in the placenta or during labour. If these foetal cells are carrying genes inherited from the father, the mother's immune system will respond by forming antibodies. If the woman later becomes a blood donor and her blood is transfused to a recipient with the same proteins as her baby, it can trigger a process whereby antibodies in the mother's donated blood bind with the white blood cells of the transfusion recipient - potentially setting off a reaction which can result in severe breathing difficulties, lung failure and death.
The risk is believed to rise with each successive pregnancy - there is currently no test available to identify contaminated blood. Donated blood from mothers accounts for one fifth of the UK supply - banning them from donating blood could drastically deplete already low blood stocks.
Last October the director of the USA's Food and Drug Administration's Centre for Biologics Evaluation and Research, Kathryn Zoon, issued a warning that the true incidence of TRALI was unknown due to misdiagnosis and underreporting. In a report in Newsday, US experts estimated that "one in every 5,000 plasma transfusions end-up as a case of TRALI and that five to 10 per cent of TRALI cases end in death. With more than 3.3 million plasma transfusions nationwide annually, that would mean as many as 660 TRALI cases and as many as 66 deaths every year".
In one particular case identified in the USA, the blood from one mother was believed to have been the cause of two deaths and 11 less serious cases of TRALI.
TRALI expert Dr Patricia Kopko, of the Sacramento Medical Foundation Blood Centres in California, said that the condition posed a greater risk to health in the USA than mad cow disease: "We don't have mad cow disease in this country. Yet, I know two people who have died in Northern California of this [TRALI] in the past two years."
America currently has a ban on the donations of blood from people who have spent extensive time in countries where BSE and nv-CJD are widespread.
The UK's Serious Hazards of Transfusion Annual Report - a voluntary reporting scheme for blood transfusion related incidents - is due out on April 9. The National Blood Service said it would carry out a full risk analysis when the current data becomes available as a matter of course.
