大阪医大耳鼻咽喉科における輸血の現況 輸血後肝炎について

Abstract

Of the 667 patients who underwent surgery under general anesthesia in our department from May 1991 to December 1993, 37 received intraoperative blood transfusions. In a study of hepatitis caused by intraoperative blood transfusion, we surveyed the results of serum examinations, including transaminase, in these 37 patients. In this comparison of data, studies were extended to patients who received intraoperative blood transfusion in 1989, the year before the introduction of routine screening of blood for HCV. There was no difference in the range of fluctuation of postoperative transaminase values between the 1991.1993 and the 1989 patients. According to the criteria for the clinical diagnosis of HCV, HCV was found in only one of 10 patients 1989 and in one of 37 patients in 1991 to 1993. The last mentioned patient had a negative routine serum test for HCV. An other postoperative unfavorable event due to intraoperative blood transfusion was toxoplasma infection. Although the incidence of post-transfusion hepatitis has become much lower, we should continue to strive to reduce it still further. As one effective measure, we are now using autologous blood transfusion in selected cases. This method is promising for the future and will be come routine in the clinical practice of surgery.