[Evaluation of post transfusion hypertransaminasemia]

Dosage of post transfusion ALT has been performed since a government recommendation was issued in 1996. Yet, the advantage of this analysis during the post transfusion tests has not been determined. The aims of this study were to estimate: a) the incidence of hypertransaminasemia, b) the causes of hypertransaminasemia and c) the advantage of an etiologic investigation.

At the University Hospital of Brest, follow-up of the labile blood products recipients was initiated in June 1993. Since 1997, a visit in the hepatogastroenterology unit was systematically proposed to patients having post transfusion hypertransaminasemia.

Since November 1997 to July 2003, ALT increase was detected in 235 patients (4%). Among them, 108 patients consulted a hepatologist. Diagnosis was certain for 46 patients (46%). A drug reaction or alcoholic disease was the cause of ALT elevation in the majority of cases (80%). The diagnosis was probable for 42 patients (39%) due to medications in 81% of cases. The diagnosis remained undetermined in 20 patients (18%).

Our study shows that alcohol or drug hepatotoxicity explained the majority of post transfusion hypertransaminasemia. We could not demonstrate a viral cause. We have decided to continue the follow-up of post transfusion hypertransaminasemia during two more years and to reevaluate the usefulness of the etiologic investigation.