Donor ALT Testing as Means to Reduce Posttransfusion Hepatitis

Abstract

The policy of testing all blood donors for the presence of HBsAg has not succeeded in eliminating posttransfusion hepatitis. This is because the majority of cases are non-A, non- B (NANB) hepatitis; serologic tests for carriers of this disease are not available. The incidence of apparent NANB infection among blood recipients maybe as high as 10-12%. Recent studies suggest that blood donors with elevated alanine aminotransferase (ALT) levels are more often associated with this infection in recipients. Implementation of donor ALT testing would result in a number of problems including attrition of the blood resource, difficulties in test standardization and interpretation, development of a rationale for donordeferral and counseling, and significant additional costs for provision of blood. There is a lack of information about the extent and severity of clinically significant posttransfusion NANB hepatitis. A careful analysis of the advantages and disadvantages of ALT testing should be completed before any measures are taken to develop policies in this area.