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Volume 13, Number 1—January 2007
Research

Blood Transfusion and Spread of Variant Creutzfeldt-Jakob Disease

Klaus Dietz*Comments to Author , Günter Raddatz*, Jonathan Wallis†, Norbert Müller‡, Inga Zerr§, Hans-Peter Duerr*, Hans Lefèvre¶, Erhard Seifried#, and Johannes Löwer**
Author affiliations: *University of Tübingen, Tübingen, Germany; †Freeman Hospital, Newcastle upon Tyne, United Kingdom; ‡University Hospital Essen, Essen, Germany; §University of Göttingen, Göttingen, Germany; ¶DRK Blood Donor Service West, Hagen, Germany; #DRK Blood Donor Service Baden-Württemberg, Hessen, Frankfurt am Main, Germany; **Paul-Ehrlich-Institute, Langen, Germany;

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Table 1

Summary of input parameters for the model*

ParametersDescriptionSource
Age-specific mortality ratesU-shaped, with minimum at age 10.Federal Statistical Office of Germany
Donor recruitmentDonors ages 18–67 y. Maximum recruitment rate at age 18, lower plateau ages 25–50; further decrease until age 67.Age-distribution of first-time donors at DRK Blood Service and age structure in population
Proportion of donors3% of population.DRK Blood Service West
Duration as active donorDonors ages 18–40 y, mean duration as active donor 10–14 y, decreases linearly to 0.Age distribution of active donors at DRK Blood Service West, by age at first donation
Risk of receiving transfusionsBimodal, with peaks for newborns and aged persons. Multiple transfusions possible.Data collected from 4,867 patients March 2003, University Hospital Essen, Germany
Transfusion-associated risk for deathIncreases according to a sigmoid function, ≈17% at birth to ≈48% in old age. For those with transfusion-associated risk for death, life expectancy is ≈2.5 years at birth and decreases to ≈0.5 y in old age.Follow-up of ≈3,000 transfusion recipients for ≈7.5 y in Newcastle, UK (4)
Alimentary infectionConstant over an initial period of 10 y.Arbitrary assumption
Incubation period†Gamma distributed with mean 16 y, SD 4 y. Sensitivity analysis with mean = 50 y and same coefficient of variation.Models fitted to the UK incidence of vCJD (5,6)
Donor exclusionEither 0 or 95% of those with transfusion history.Arbitrary assumption

*DRK, German Red Cross; SD, standard deviation; vCJD, variant Creutzfeldt-Jakob disease.
†Time between infection and death, i.e., duration of infection.

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