Access to Surgical Procedures
In 2004, following a UK Risk assessment, people with haemophilia who had been exposed to UK plasma-derived factor concentrates between 1986 and 2001 were designated at risk (for public health purposes) of having potentially been exposed to vCJD. This was due to the fact that a number of plasma pools in the UK used to manufacture plasma-derived factor concentrates contained a donation (among thousands of donations in a pool) from a donor who later developed vCJD. This was and remains a highly precautionary step. No person with haemophilia has ever developed clinical vCJD. A significant number of people with haemophilia from Ireland had used some plasma-derived factor concentrates from the UK between 1986 and 2001 and therefore this was noted in their medical charts. The practical ramifications were that, if they required certain surgical procedures, disposable surgical instruments would be used and if they required endoscopies- a not uncommon procedure in our members- the endoscope used would be quarantined and retained for their sole use or destroyed. This was due to the theoretical risk of transmission of prions- the abnormal proteins which cause vCJD.
This risk assessment has been kept under review and changes have now been made based on an updated risk profile and the absence of any cases of vCJD. The applicable years where people will be designated at risk has been narrowed to 1990 to 2001. Further changes have been made to procedures for endoscopy and surgeries. Endoscopes used for people with haemophilia who are designated at risk will no longer require quarantine or destruction. They will be decontaminated using the normal procedure for endoscopes and returned to general use. Less severe restrictions will also apply to some surgical instruments which have undergone repeated cycles of decontamination. These new guidelines may prevent any delay in access to surgery or endoscopy for our members designated as at risk.