Although effective means currently exist for diminishing the transmission of hepatitis B (serum hepatitis) by blood transfusion, post-transfusion hepatitis continues to be one of the major serious complications of the administration of blood and blood products. In behooves the hematologist to keep abreast of developments in this field because of their large usage of potentially icterogenic products and their responsibility to blood banking. The purpose of this article is to review briefly the history of post-transfusion hepatitis, show how recent changes in blood banking practices have decreased this hazard and describe the existent hepatitis problems associated with blood component therapy.
Hepatitis is an ancient disease described by Hippocrates. However, parented transmission was not known until 1883 when an outbreak developed among individuals vaccinated against smallpox with a lymph of human origin (1). Earlier in this century, jaundice was observed among patients attending diabetic and veneral disease clinics where syringes and needles were inadequately sterilized. In 1938, Findlay and MacCallum described the occurrence of jaundice among individuals two to seven months after inoculation with yellow fever vaccine and correctly surmised that the icterus was caused by a virus in the human sera which had been added as a stabilizer for the vaccine (2). A similar occurrence was subsequently reported following the use of convalescent serum to prevent measles (3). Widespread recognition of this problem did not occur until 1942 when there was a massive outbreak of hepatitis among United States military personnel following inoculation with a yellow fever vaccine that contained human sera (4). Although posttransfusion hepatitis had not been described in 1942, the American Red Cross Blood Donor Service began to reject all donors with a history of jaundice within the previous six months as a precautionary measure (5). In 1943, Beeson first described patients who developed hepatitis one to four months after the transfusion of blood or plasma (6). Recognition of this problem rapidly increased with subsequent reports providing confirmatory information.