A multicenter, prospective study of posttransfusion hepatitis in Milan

Area of Science:

• Hepatology
• Infectious Diseases
• Transfusion Medicine

Background:

• Blood transfusions are essential medical procedures.
• Posttransfusion hepatitis poses a risk to patient safety.
• Donor screening aims to minimize transfusion-transmitted infections.

Purpose of the Study:

• To assess the incidence of posttransfusion hepatitis in recipients receiving blood from donors screened for HBsAg and ALT levels.
• To identify the types and clinical outcomes of hepatitis developing after transfusion.
• To evaluate the effectiveness of current screening methods in preventing hepatitis transmission.

Main Methods:

• A prospective study of 676 patients receiving blood or plasma transfusions between October 1983 and September 1984.
• Exclusion of patients with prior liver disease or previous transfusions.
• Monitoring of patients for hepatitis development, including serological testing and ALT level monitoring.

Main Results:

• An overall incidence of 20 cases of posttransfusion hepatitis per 1,000 units of transfused blood was observed.
• Non-A, non-B hepatitis was the predominant form, accounting for 92 of 96 cases.
• Hepatitis B occurred in 3 patients, and cytomegalovirus infection in 1 patient.
• A significant association was found between the number of blood units transfused and hepatitis development (p < 0.001).
• Many cases of non-A, non-B hepatitis were asymptomatic, but 60% still had elevated ALT levels one year later.

Conclusions:

• Non-A, non-B hepatitis remains a common complication of blood transfusion.
• Current donor screening for HBsAg and ALT is insufficient to eliminate the risk of transfusion-transmitted hepatitis.
• Further strategies are needed to improve blood safety and prevent non-A, non-B hepatitis transmission.