Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-14T22:11:24.076Z Has data issue: false hasContentIssue false
  • English
  • Français

Post-transfusion hepatitis in a London hospital: results of a two-year prospective study

Published online by Cambridge University Press:  15 May 2009

Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Seven hundred and sixty-eight patients were seen and tested at frequent intervals after transfusion of whole blood. Eight patients were judged to have developed icteric or anicteric post-transfusion viral hepatitis, an incidence of 1%. Five were icteric and four of these were hepatitis B antigen (HB Ag) positive; two of these four died. One of the fatal cases and one non-fatal HB Ag positive case had received HB Ag positive blood. Two other antigen-positive patients had received blood or plasma or both which had not been tested for antigen.

Thirty-five patients showed conspicuous or sustained elevations of alanine transaminase without clinical features of hepatitis.

Four were positive for HB Ag but had not received antigen positive blood.

Two who had received antigen positive blood remained antigen negative, but one developed hepatitis B antibody (HB Ab).

Two other patients were also transfused with plasma.

Five had serological evidence of cytomegalovirus (CMV) infection accompanying the enzyme changes.

One patient who had received HB Ag positive blood remained antigen-negative and showed no abnormalities.

Five patients who became HB Ag positive, although they had been given antigen-negative blood, remained clinically and biochemically well.

Cytomegalovirus primary infection or reactivation occurred in another 32 patients; five had isolated, transient enzyme rises, one other was associated with a drug-induced focal liver necrosis and 26 showed no enzyme changes. Epstein–Barr virus infections, one of which was associated with a transient upset of enzyme activity, were detected in five patients. There were no cases of post-perfusion syndrome.

Type
Research Article
Information
Journal of Hygiene , Volume 73 , Issue 2 , October 1974 , pp. 173 - 188
Copyright
Copyright © Cambridge University Press 1974

References

REFERENCES

Allen, J. G.Dawson, D.Sayman, W. A.Humphreys, E. M.Denham, R. S. & Havens, I. (1959). Blood transfusions and serum hepatitis. Use of monochloroacetate as an antibacterial agent in plasma. Annals of Surgery 150, 455–68.CrossRefGoogle ScholarPubMed
Alter, H. J.Holland, P. V., Purcell, R. H., Lander, J. J., Feinstone, S. M., Morrow, A. G. & Schmidt, P. J. (1972). Post-transfusion hepatitis after exclusion of commercial and hepatitis-B antigen-positive donors. Annals of Internal Medicine 77, 691–9.CrossRefGoogle Scholar
Bergmeyer, H. U. & Bernt, E. (1963).Glutamate-pyruvate transaminase In Methods of Enzymatic Analysis, pp. 846–51. New York and London: Academic Press.Google Scholar
Blumberg, B. S., Gerstley, B. J. S., Hungerford, D. A., London, W. T. & Sutnick, A. I. (1967). A serum antigen (Australia antigen) in Down's syndrome, leukemia and hepatitis. Annals of Internal Medicine 66, 924–31.CrossRefGoogle ScholarPubMed
Bowers, G. N. & McComb, R. B. (1966). A continuous spectrophotometric method for measuring the activity of serum alkaline phosphatase. Clinical Chemistry 12, 70–89.CrossRefGoogle ScholarPubMed
Cherubin, C. E. (1971). The risk of post-transfusion hepatitis in recipients of blood containing SH antigen at Harlem Hospital. Lancet i, 627–30.CrossRefGoogle Scholar
Creutzfeldt, W., Severidt, H. J., Schmitt, H., Gallasch, E., Arndt, H. J., Brachmann, H., Schmidt, G. & Tschaepe, U. (1966). The incidence and course of icteric and anicteric transfusion hepatitis. German Medical Monthly 11, 469–76.Google ScholarPubMed
Epstein, M. A., Achong, B. G. & Barr, Y. M. (1964). Virus particles in cultured lymphoblasts for Burkitt's lymphoma. Lancet i, 762–3.Google Scholar
Grusti, G., Ruggiero, G. & Cacciatore, L. (1969). A comparative study of some spectrophotometric and colorimetric procedures for the determination of serum glutamic-oxalo-acetic and glutamic-pyruvic transaminase in hepatic diseases. Enzymologia Biologica et Clinica 10, 17–38.Google Scholar
Grady, G. F., Chalmers, T. C. & The, Boston, Inter-Hospital, Liver Group (1964). Risk of post-transfusion viral hepatitis. New England Journal of Medicine 271, 337–42.CrossRefGoogle ScholarPubMed
Hampers, C. L., Prager, D. & Senior, J. R. (1964). Post-transfusion anicteric hepatitis. New England Journal of Medicine 271, 747–54.CrossRefGoogle ScholarPubMed
Henle, G. & Henle, W. (1966). Immunofluorescence in cells derived from Burkitt's lymphoma. Journal of Bacteriology 91, 1248–56.CrossRefGoogle ScholarPubMed
Henle, G., Henle, W. & Diehl, V. (1968). Relation of Burkitt's tumour-associated herpes-type virus to infectious mononucleosis. Proceedings of the National Academy of Sciences of the U.S.A. 59, 94–101.CrossRefGoogle Scholar
Henle, W., Henle, G., Scriba, M., Joyner, C. R., Harrison, F. S., Von Essen, R., Paloheimo, J. & Klemola, E. (1970). Antibody responses to the Epstein–Barr and cytomegaloviruses after open-heart and other surgery. New England Journal of Medicine 282, 1068–74.CrossRefGoogle Scholar
Katz, R., Rodriguez, J. & Ward, R. (1971). Post-transfusion hepatitis: effect of modified gamma-globulin added to blood in vitro. New England Journal of Medicine 285, 925–32.CrossRefGoogle ScholarPubMed
Lehane, D., Kwantes, C. M. S., Upward, M. G. & Thomson, D. R. (1949). Homologous serum jaundice. British Medical Journal ii, 572–4.CrossRefGoogle Scholar
McCollum, R. W. & Zuckerman, A. J. (1970). Application of laboratory methods. Tests for Australia (hepatitis-associated) antigen and antibody. Bulletin of the World Health Organization 42, 987–92.Google Scholar
Ministry of Health (1954). Homologous serum jaundice after transfusion of whole blood, dried small-pool plasma, dried irradiated plasma and kaolin-treated filtered liquid plasma. Lancet i, 1328–9.Google Scholar
Paloheimo, J. A., Von Essen, R., Klemola, E., Kaariaken, L. & Siltanen, P. (1968). Subclinical cytomegalovirus infections and cytomegalovirus mononucleosis after open-heart surgery. American Journal of Cardiology 22, 624–30.CrossRefGoogle ScholarPubMed
Pereira, M. S., Blake, J. M. & Macrae, A. D. (1969). EB Virus antibody at different ages. British Medical Journal iv, 526–7.CrossRefGoogle Scholar
Prince, A. M. (1968). An antigen detected in the blood during the incubation period of serum hepatitis. Proceedings of the National Academy of Sciences of the U.S.A. 60, 814–21.CrossRefGoogle ScholarPubMed
Prince, A. M., Szmuness, W., Millian, S. J. & David, D. S. (1971). A serologic study of cytomegalovirus infections associated with blood transfusions. New England Journal of Medicine 284, 1125–31.CrossRefGoogle ScholarPubMed
Reitman, S. & Frankel, S. (1957). A colorimetric method for the determination of serum glutamic oxaloacetic and serum glutamic-pyruvic transaminases. American Journal of Clinical Pathology 28, 56–63.CrossRefGoogle Scholar
Shimizu, Y. & Kitamoto, O. (1963). The incidence of viral hepatitis after blood transfusions. Gastroenterology 44, 740–4.CrossRefGoogle ScholarPubMed
Somayaji, B. N., Stone, W. D. & Glover, P. B. (1967). Risk of anicteric hepatitis following blood transfusion. Gut, 8, 614–17.CrossRefGoogle ScholarPubMed
Spurling, N., Shone, J. & Vaughan, J. (1946). The incidence, incubation period and symptomatology of homologous serum jaundice. British Medical Journal ii, 409–12.CrossRefGoogle Scholar
Stern, H. & Elek, S. D. (1965). The incidence of infection with cytomegalovirus in a normal population. A serological study in Greater London. Journal of Hygiene 63, 79–87.CrossRefGoogle Scholar
Stevens, D. P., Barker, L. F., Ketcham, A. S. & Meyer, H. M. Jr. (1970). Asymptomatic cytomegalovirus infection following blood transfusion in tumor surgery. Journal of the American Medical Association 211, 1341–4.CrossRefGoogle ScholarPubMed
Taylor, P. E. (1970). Viral hepatitis and tests for the Australia (hepatitis-associated) antigen and antibody. IV. Complement fixation tests. Bulletin of the World Health Organization 42, 966–73.Google Scholar
Walsh, J. H., Purcell, R. H., Morrow, A. G., Chanock, R. M. & Schmidt, D. J. (1970). Post transfusion hepatitis after open-heart operations. Incidence after the administration of blood from commercial and volunteer donor populations. Journal of the American Medical Association 211, 261–5.CrossRefGoogle Scholar
Zuckerman, A. J. (1970 a). In Virus Diseases of the Liver. London: Butterworth.Google Scholar
Zuckerman, A. J. (1970 b). Viral hepatitis and tests for the Australia (hepatitis-associated) antigen and antibody. VI. Electron microscopy and immune electronmicroscopy. Bulletin of the World Health Organization 42, 975–8.Google Scholar
Zuckerman, A. J. (1972). In Hepatitis-associated Antigen and Viruses. Amsterdam: North Holland Publishing Company.Google Scholar
Zuckerman, A. J. & Taylor, P. E. (1969). Persistence of serum hepatitis (SH-Australia) antigen for many years. Nature, London 223, 81–2.CrossRefGoogle ScholarPubMed