輸血後肝炎の臨床病理学的研究

第2編 発生状況

抄録

A study was conducted to elucidate the occurence of post-transfusion hepatitis on the basis of the criteria established in the previous report (Part I).
The subjects for this investigation were 190 cases out of the 259 cases who received surgicical opertion and blood transfusion during the period from September, 1964 to January, 1965 in the Okayama University Hospital along with 46 cases of the control. They were followed up at intervals one week, and once every month periodically after the blood transfusion by checking mainly their liver function at our outpatient clinic. These subjects were consisted of 22 cases operated for the head and spine, 39 cases for the heart and large vessels, 28 cases for the upper abdomen, 91 cases for the viscera in hypogastric region (cancer of uterus, rectum, etc.) and 10 cases for others.
By the criteria for the post-transfusion hepatitis 76 cases (40%) out of the 190 proved to be positive, but none in the control group. The histoloical examination of the liver by endoscopic biopsy revealed two cases of diabetics. Thus, in making the correction on the basis of biopsy diagnosis, the incidence of post-transfusion hepatitis amounts to 74/190 cases or 38.9%. Of them icteric hepatitis amounts to 12.1%, making 68.9% of them to be of anicteric type. Relative to the site of operation, the incidendence of post-transfusion hepatitis is 61.5% in those operated for the heart and large vesses, 54.5% in those for the head and spine, 33.0% in those for the viscera in hypogastric region, and 21.4% in those for the upper abdomen. The incidence of icteric type was higher in those operated for the head and spine (18.2%) than the heart and large vessels (15.4%). As for infants the majority of whom underwent heart operation, the follow-up study by examination of the liver function revealed 14 cases (56%) out of 25, showing a high rate of post-transfusion hepatitis, and the incidence of the icteric type was as low as two cases (8%) which accounts for a relatively low incidence of juandice in the group of the heart and large vessels. The amount of transfused blood is most closely related to the rate of incidence of this disease, and differences in the incidence due to the operation site, sex, age and the kinds of blood, can be explained by their relation to the amount of blood transfused. Further, it has been demonstrated that irrespective of fresh blood or other donated or stocked blood, the incidence of post transfusion hepatitis grows higher in proportion to the increase in the amount of blood transfused.
Apart from these results, there were observed some cases developing this condition on even when the blood donor had no abnormality of the liver function, proving that it is extremely difficult to detect silent carrier that induces post-transfusion hepatitis.