[Frequency of hepatitis after extra-corporeal circulation].

Area of Science:

• Hepatology
• Virology
• Cardiovascular Surgery

Context:

• Hepatitis B virus (HBV) transmission poses a risk in cardiovascular surgery, particularly after extracorporeal circulation (ECC).
• Assessing the efficacy of hepatitis B surface antigen (HBsAg) screening in blood donors is critical for patient safety.
• Previous screening methods showed varying effectiveness in preventing post-transfusion hepatitis.

Purpose:

• To evaluate the impact of systematic HBsAg screening in blood donors on the incidence of icteric hepatitis following ECC.
• To compare the effectiveness of different HBsAg screening techniques (immuno-diffusion, counter-electrophoresis, complement fixation) in reducing viral hepatitis transmission.
• To identify patient demographics associated with a higher risk of post-transfusion hepatitis.

Summary:

• The study analyzed three groups of patients undergoing ECC: no screening, immuno-diffusion screening, and advanced screening (counter-electrophoresis, complement fixation).
• Incidence of icteric hepatitis decreased from 6.7% without screening to 4.6% with systematic advanced screening.
• Hepatitis was more frequent in males and older patients; recovery was typically within 2 months, but severe and fatal cases occurred.

Impact:

• Systematic HBsAg screening, especially using sensitive methods like radio-immuno-assay and reverse passive haemagglutination, is essential to minimize post-transfusion hepatitis risk.
• Current screening tests are effective against HBV but may not prevent transmission of other hepatitis virus strains.
• The findings advocate for the daily use of the most sensitive HBsAg screening tests in blood banks to enhance transfusion safety.