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[Evaluation of post transfusion hypertransaminasemia]
C Le Niger1, O Savary, L Lepiouf
1Unité d'hémovigilance, CHU Morvan, 5, avenue Foch, 29609 Brest cedex, France. catherine.leniger@chu-brest.fr
Summary
Post-transfusion alanine aminotransferase (ALT) elevation is often caused by alcohol or drug hepatotoxicity, not viral infections. Further investigation into the benefits of etiological studies for transfusion recipients is warranted.
Area of Science:
- Hepatology
- Transfusion Medicine
- Clinical Biochemistry
Background:
- Post-transfusion alanine aminotransferase (ALT) monitoring has been standard since 1996.
- The clinical utility of investigating elevated ALT levels after blood transfusions remains unclear.
Purpose of the Study:
- To determine the incidence of hypertransaminasemia post-transfusion.
- To identify the causes of post-transfusion hypertransaminasemia.
- To evaluate the benefit of etiological investigations for these cases.
Main Methods:
- Follow-up of blood product recipients initiated in 1993.
- Systematic consultation offered to patients with post-transfusion hypertransaminasemia since 1997.
- Hepatologist evaluation for diagnosed cases.
Main Results:
- ALT elevation detected in 4% (235/5875) of patients between 1997 and 2003.
- Hepatotoxicity from alcohol or drugs accounted for the majority (80%) of confirmed causes.
- Viral causes were not identified in the investigated cases.
Conclusions:
- Alcohol or drug-induced hepatotoxicity is the primary cause of post-transfusion hypertransaminasemia.
- Viral etiologies were not established in this cohort.
- Continued follow-up and re-evaluation of etiological investigation usefulness are planned.