Relationship between guanase activity in donor blood and the incidence of posttransfusional non-A, non-B hepatitis, and a possible method for preventing posttransfusional hepatitis

✍ Scribed by Susumu Ito; Yasuhiro Tsuji; Akiharu Iwasaki; Naoyuki Kitagawa; Yoshiyuki Tamura; Setsuro Fujii

• Publisher: John Wiley and Sons
• Year: 1986
• Tongue: English
• Weight: 427 KB
• Volume: 6
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.1840060530

✦ Synopsis

A total of 107 recipients, who did not show any evidence of hepatic disorders in pretransfusional liver function tests and gave a negative reaction for HBsAg, were observed from 3 weeks to 3 months after blood transfusion of 71 1 units of blood. The blood was judged suitable for use in transfusion because it had a normal level of ALT activity and gave a negative reaction for HBsAg. The guanase activities of the blood used for transfusion were examined. Cases in which an increase of ALT to at least twice the upper limit of normal persisted for at least 3 weeks and the ALT value increased to more than five times the normal upper limit at least once during this period, which also gave a negative reaction for HBsAg, were judged to have posttransfusional non-A, non-B hepatitis. Of 107 recipients, 18 developed posttransfusional non-A, non-B hepatitis. It was detected in 2 of 71 recipients (3%) with blood guanase activities below 3.5 units per liter and in 16 of 36 recipients (44%) with blood guanase activities above 3.6 units per liter. Thus, the incidence of posttransfusional non-A, non-B hepatitis was significantly higher in recipients with blood guanase activities above 3.6 units per liter. The incidence of posttransfusional non-A, non-B hepatitis increased linearly with increase in the level of guanase activity in donor blood. Thus, a high guanase activity in donor blood is considered to be an important predicting factor for posttransfusional non-A, non-B hepatitis. It is proposed that development of posttransfusional non-A, non-B hepatitis could be reduced by avoiding use of donor blood with guanase activities above 3.6 units per liter.

In humans, guanase (guanine deaminase, EC 3.5.4.3) is present mainly in the liver, brain and kidney, with little or no activity in other tissues. Passanenti (1) first reported that guanase appears in the plasma of patients with liver damage. Subsequently, the clinical significance