Clinical significance of elevated alanine aminotransferase in blood donors: a follow-up study.
Alanine aminotransferase (ALT) elevation in blood donors can be related to many variables such as viral hepatitis, overweight and ethanol consumption.


OBJECTIVE
This study aims to define factors associated with ALT elevation in candidates for blood donation, to evaluate ALT levels during follow-up, and to establish a histological diagnosis of hepatic disease.


METHODS
Alcoholism, obesity, drug-induced liver disease, diabetes, hemochromatosis and alpha 1-anti-trypsin deficiency were investigated in 119 subjects (113 males, six females, aged 33.4+/-8.4 years) who were hepatitis B surface antigen/anti-hepatitis C virus negative and had been rejected as blood donors as a result of elevated ALT (>1.5 times the upper normal limit (UNL) in two determinations). During follow-up, ALT was determined every 8 weeks and liver biopsy recommended in cases with persistently elevated ALT levels.


RESULTS
Obesity (30.2%) and alcoholism (28.6%) were most frequently associated with ALT elevation and in 9.2% of cases no association was found. ALT levels decreased significantly, regardless of the associated factor. Liver histology in 40 patients showed steatosis (35%), steatohepatitis (30%), non-specific reactive hepatitis (12.5% of cases), normal liver (15% of cases) and alcoholic cirrhosis, hemochromatosis and non-specific portal fibrosis in three cases.


CONCLUSIONS
ALT levels usually dropped during follow-up and although severe hepatic lesions can be found in asymptomatic blood donors, mild hepatic damage is the rule.
Torezan-Filho
Mario Antonio
MA
Department of Pathology, University of São Paulo School of Medicine, São Paulo, Brazil. simatorezan@uol.com.br
Alves
Venancio Avancini Ferreira
VA
Neto
César Almeida
CA
Fernandes
Helena Sabino
HS
Strauss
Edna
E
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D001707:Biopsy, Needle; D001782:Blood Donors; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008107:Liver Diseases / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology; D011336:Probability; D018570:Risk Assessment; D012680:Sensitivity and Specificity
D015415:Biomarkers; D000410:Alanine Transaminase