title: Post-transfusional hepatitis in neonates hospitalized in a Neonatal Intensive Care Unit.
abstract: OBJECTIVE
  To assess the significance of increased serum transaminase levels in neonates admitted to a Neonatal Intensive Care Unit and its relationship with blood transfusion.
  
  
  METHODS
  Follow-up prospective study of 209 patients; 177 completed follow-up, of whom 129 were transfused and 48 were not; 57 were born after full gestation and 120 were born prematurely. The activity of serum levels of ALT, AST, and GGT was measured monthly up to six months of age, and until six months after the last transfusion. At the end of follow-up, and whenever an increase in serum transaminase levels was detected, the viral agents of hepatitis A, B, C, G, TT, cytomegalovirus, Epstein-Barr, and herpes 1 and 2, and toxoplasma were studied. Viral serology was also carried out in mothers and in donors when children tested positive.
  
  
  RESULTS
  One hundred twenty nine neonates (73%) received 461 U red blood cell transfusions (3.6 +/- 3 U/patient). ALT levels increased in 54 (30.5%) patients, of whom 46 (36%) were transfused and eight (17%) were not (p < 0.05). The independent variables were 'infection by G virus' and 'parenteral nutrition for more than 12 days'; the variable 'transfusion' was close to the limit for statistical significance. Twenty patients (11.3%) had increased serum ALT levels 2.5 times above the normal value: 18 (14%) were transfused and two (4%) were not (p = 0.106). Only the G and TT viruses were related with transfusion; patients remained asymptomatic, although most neonates were chronically infected.
  
  
  CONCLUSIONS
  Follow-up showed that increased serum ALT levels are common among severely ill neonates. Blood transfusions are safe concerning most hepatotropic viruses, but transmission of viruses G and TT is possible.
authors.affiliation: Departament of Pediatrics, San Cecilio University Hospital, Granada, Spain. arextrem@ugr.es
authors.forename: A
authors.initials: A
authors.lastname: Ruiz Extremera
authors.forename: J
authors.initials: J
authors.lastname: Salmerón
authors.forename: M L
authors.initials: ML
authors.lastname: Torres
authors.forename: P
authors.initials: P
authors.lastname: Muñoz de Rueda
authors.forename: E
authors.initials: E
authors.lastname: Ocete
authors.forename: J D
authors.initials: JD
authors.lastname: Luna
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006525:Hepatitis, Viral, Human / Q000097:blood / Q000209:etiology*; D006760:Hospitalization; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D011446:Prospective Studies; D000637:Transaminases / Q000097:blood; D065227:Transfusion Reaction
chemical_list: D000637:Transaminases