Can we make blood transfusions safer by testing for proteins linked to strokes and Alzheimer's disease?

A review published in The Lancet investigates the potential risks of blood transfusions transmitting harmful brain proteins that could lead to strokes and Alzheimer's disease. Professor John Collinge, the lead researcher, emphasizes the importance of thoroughly investigating any potential risks to ensure the safety of blood transfusions.

The study reviews evidence of amyloid-beta, a protein associated with Alzheimer's disease and cerebral amyloid angiopathy (CAA), which causes brain hemorrhages. A 2023 Scandinavian study found recipients of blood from donors who later developed brain bleeds had a higher risk of experiencing similar events themselves, although this does not prove causation.

The possibility of transmitting amyloid-beta through blood transfusions is raised due to iatrogenic cases of CAA and Alzheimer's disease caused by historical medical treatments. These treatments, such as childhood procedures using cadaveric dura mater and c-hGH, have led to cases of iatrogenic CAA and Alzheimer's disease decades later.

The researchers highlight the need for improved tests to evaluate the potential risks from contemporary medical procedures, as the development of good tests for amyloid-beta infectivity has been challenging. The UK Infected Blood Inquiry report, which investigated the transmission of HIV and hepatitis C through contaminated blood, also serves as a cautionary tale, emphasizing the importance of proactively mitigating potential risks to patient safety.