Post-transfusion hepatitis after open-heart surgery in Finland--a prospective study

Area of Science:

• Hepatology
• Infectious Diseases
• Transfusion Medicine

Background:

• Post-transfusion hepatitis (PTH) is a significant concern in transfusion recipients.
• Hepatitis C virus (HCV) was not identifiable in Finland until 1989, making non-A, non-B hepatitis (NANBH) diagnosis challenging prior to this.
• Open-heart surgery patients are at high risk due to extensive blood product usage.

Purpose of the Study:

• To determine the prevalence and characteristics of post-transfusion hepatitis in Finnish open-heart surgery patients.
• To assess the risk of NANBH transmission through blood products in this vulnerable population.
• To evaluate the incidence of NANBH following coronary bypass surgery.

Main Methods:

• A prospective, countrywide study involving 685 open-heart surgery patients between 1987-1989.
• Patients received an average of 12.3 units of blood products and were followed for 6 months postoperatively.
• Hepatitis diagnosis based on elevated alanine aminotransferase (ALT) levels, excluding non-viral causes.

Main Results:

• Eleven cases (1.6%) of NANBH were identified with a mean incubation period of 8.4 weeks.
• Two patients experienced jaundice; 55% showed prolonged ALT abnormalities, suggesting potential chronicity.
• The incidence of NANBH was 1.3 cases per 1000 units of blood products, lower than previously reported rates.

Conclusions:

• The study indicates a low prevalence of NANBH in Finnish open-heart surgery patients during the study period.
• The observed low rate of NANBH suggests effective blood screening and management practices.
• Further research is warranted to monitor transfusion-transmitted hepatitis trends.