[Screening for markers of transfusion-associated infections in autologous blood donation]

Autologous blood donation is increasingly used in preparing patients for elective surgical procedures. The aim is to diminish the transmission of transfusion-associated infections, to avoid transfusion-related immunosuppression and to relieve the general blood supply. However, autologous blood donation programs do not necessarily incorporate serologic donor screening. From June 1990 to January 1993 we examined 4,038 consecutive autologous donations from 1,708 patients. The median age was 61 years (range 10-88), the sex ratio was 1/1.5 male/female. We tested each unit for serum ALT, anti-HIV1 + 2, HBsAG, anti-HBc, anti-HCV, and Treponema pallidum antibodies (TPHA test). The overall rates of positive test results were: ALT > 45 U/l 0.64%, anti-HBc 15.9%, BHsAG 0.72% and TPHA test 0.32% of all units; anti-HCV (1st gen.) 4.26% of 1,948 and anti-HCV (2nd gen.) 2.34% of 2,090 donations. With respect to the sex-related normal range of the local laboratory, 332 (8.2%) of all components had an elevated serum ALT level. No donation was positive for anti-HIV1/2. The overall rate of components with pathological findings in tests for ALT, HCV antibodies, HBs antigen and/or Treponema antibodies was 11.7%. We conclude from these data that a substantial proportion of autologous blood is potentially harmful in cases of mistake solely with respect to serologic screening results. Procedures to minimize the risk of mistake of autologous blood should routinely include serologic screening and marking of units with pathological findings.