[Occurrence of non-A, non-B post-transfusion hepatitis in heart surgery. Prospective study on the value of the determination of serum alanine aminotransferase and detection of anti-HBc antibodies in blood donors].
We studied a group of 64 patients undergoing cardiac surgery for the occurrence of post-transfusion hepatitis during a follow-up period of 5 months. They received blood units (packed red cells in saline-adenine-glucose medium and/or fresh frozen plasma exclusively) from 447 volunteer donors. Post-transfusion hepatitis was identified in 5 patients: 1 patient had cytomegalovirus hepatitis and the remaining 4 cases were defined, by exclusion, as non-A, non-B hepatitis (with prevalence and incidence rates of 80% and 6.25% respectively). We found no statistically significant differences between the numbers of transfused blood product units in patients who developed non-A, non-B hepatitis as compared to those who did not. Our analysis of the predictive effectiveness of alanine aminotransferase and anti-HBc antibodies screening in blood donors to prevent non-A, non-B post-transfusion hepatitis led to the following conclusions: we failed to confirm the association between anti-HBc in blood donors and enhanced risk of non-A, non-B hepatitis in recipients since no case developed among patients receiving blood products from anti-HBc positive donors. So, 20 donors (4.5%) would have been discarded without any reduction of the incidence of non-A, non-B hepatitis. we could not confirm nor exclude the possibility that screening donor blood for elevated alanine aminotransferase levels would have reduced the number of non-A, non-B hepatitis in recipients.
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D001782:Blood Donors; D006348:Cardiac Surgical Procedures; D004796:Clinical Enzyme Tests; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006510:Hepatitis B Antibodies / Q000032:analysis*; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology*; D006525:Hepatitis, Viral, Human / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D065227:Transfusion Reaction
D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D000410:Alanine Transaminase
Incidence de l'hépatite non-A, non-B post-transfusionnelle en chirurgie cardiaque. Etude prospective de l'intérêt du dosage de l'alanine aminotransférase sérique et de la recherche d'anticorps anti-HBc chez les donneurs de sang.