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Alanine Aminotransferase and Posttransfusion Hepatitis

David A. Lacher, MD
JAMA. 1987;257(8):1048. doi:10.1001/jama.1987.03390080038013.
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To the Editor.—  The American Red Cross is initiating the screening of donor blood for high alanine aminotransferase (ALT) levels to reduce the incidence of posttransfusion hepatitis. Non-A, non-B hepatitis, probably caused by several viruses, is the major cause of posttransfusion hepatitis. Thirty percent of patients with posttransfusion hepatitis are symptomatic, and some develop chronic hepatic disease. Hepatitis B has been virtually eliminated as a source of posttransfusion hepatitis by testing donor blood for hepatitis B surface antigen.Aach et al1 prospectively followed up 1513 transfusion recipients and found that the incidence of posttransfusion hepatitis was directly related to the ALT concentration in blood donors. The overall attack rate for non-A, non-B hepatitis was 10%, but recipients of donor units with an ALT concentration of 60 U/L or greater had a 45% attack rate. The direct relationship between transfusion hepatitis and donor ALT levels was confirmed by Alter et


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