Eye banking and screening for Creutzfeldt-Jakob disease

Objectives: To quantify the risk of Creutzfeldt-Jakob disease (CJD) among c ornea donors, evaluate supplemental screening strategies, and address conce rns about the adequacy of current methods of screening tissue donors in the United States. Methods: Reported data on deaths due to CJD and from all causes were used t o estimate the rate of CJD among cornea donors. The impact of increased scr eening on risk of CJD and donor supply was evaluated. Results: Only 1.3 of the approximately 45000 cornea donors in the United St ates each year might be expected to have CJD. Most of the estimated risk (9 1%) is due to preclinical (asymptomatic) disease and therefore could not be eliminated by screening for signs or symptoms. If only the highest-risk ag e group (60 to 69 years) were screened and specificity were 90%, more than 21 000 otherwise acceptable donors would incorrectly be ex eluded over a pe riod of 17.5 years to correctly exclude a single donor with symptomatic CJD . Conclusions: Currently, the risk of CJD transmission following cornea trans plantation is remarkably low. Screening for symptoms of CJD would have mini mal impact on safety, but would reduce donor supply and likely result in ma ny patients not receiving needed treatment.