Observing the exclusion criteria for donated grafts should ensure the risk is small

The public and political profile of transmissible spongiform encephalopathies has changed dramatically with the identification of a new variant of Creutzfeldt-Jakob disease1 and continued uncertainty about the size of the threat this may represent. Against this background, the Scottish Office confirmed last month that ocular tissue from a donor who was later found to have classic (sporadic) Creutzfeldt-Jakob disease had been transplanted into three patients. Press coverage of this announcement is certain to stimulate concern among potential recipients of corneal grafts and a reanalysis of measures to prevent iatrogenic disease transmission.

latrogenic transmission of Creutzfeldt-Jakob disease was first reported in 1974 in a 55 year old woman who developed symptoms 18 months after corneal transplantation from a donor who was found to have died of the disease.2 Two similar cases have since been identified,3 and the potential for transmission of spongiform encephalopathies, including Creutzfeldt-Jakob disease, via …