Reduction of post-transfusion hepatitis by exclusion of Australia antigen from donor blood in an urban public hospital
This work supported by USPHS grants CA-06551, CA-06927, and RR-05539 from the National Institutes of Health; Contract No. N00014-67-A-046-005 from the Office of Naval Research; and by an appropriation from the Commonwealth of Pennsylvania.
Post-transfusion hepatitis occurred in ten of 56 (17.9 per cent) patients in 1963-1964, and in 14 of 78 (17.9 per cent) patients in 1968-1969 at Philadelphia General Hospital (PGH). Since November 1969 all donor blood has been tested for Australia antigen (Au) by immunodiffusion and later by counterelectrophoresis, and no positive units have been transfused. All patients were screened by stringent criteria to exclude any pre-existing liver disease and had repeated follow-up examinations after transfusion, including clinical examination, as well as serial serum glutamic pyruvic transaminase (SGPT) and Au determinations. Among 204 patients receiving Au-negative donor blood who could be followed adequately for six months, 12 (5.9 per cent) hepatitis patients (four icteric) were detected. These results indicate a two thirds reduction from the 18 per cent incidence in post-transfusion hepatitis at PGH found on two previous studies. Au testing to exclude positive donors and administering only Au-negative blood, and the changes in composition of the donor population which resulted, were effective in reducing the incidence of post-transfusion hepatitis.
