The effect of immunoglobulin for preventing post-transfusion hepatitis was studied. Following the method proposed by Creutzfeldt et al. and Katz et al., γ-globulin for intravenous use was added to blood in vitro before transfusion.
One hundred and sixty patients who had undergone cardiovascular surgery and blood transfusion from January 1978 to Feburuary 1980 were divided into 2 groups. 52 patients (control group) were transfused without γ-globulin. The remaining 108 patients (treated group) were performed transfusion following addition of 250mg or 500mg of Gamma-Venin to each 200ml of blood in vitro. Hepatic function test were performed for all the patients once a week at least 8 weeks after the first transfusion.
The incidence of post-transfusion hepatitis was as follows:
1) 16 cases (30.8%) in control group and 16 cases (14.8%) in treated group conforming to criterion of post-transfusion hepatitis (I)
2) 7 cases (13.5%) in control group and 5 cases (4.6%) in treated group conforming to criterion of post-transfusion hepatitis (II)
3) 4 cases (7.7%) in control group and none in treated group conforming to criterion of posttransfusion hepatitis (III) respectively.
Thus the incidence of post-transfusion hepatitis was significantly lower in treated group for all 3 criteria.
There was no significant difference between control group and treated group in incubation period and duration of post-transfusion hepatitis.
At present, it is impossible to exclude the carrier of non-A, non-B hepatitis virus from blood donors, therefore, the addition of immunoglobulin to blood in vitro is considered to be the most reasonable and reliable method to prevent post-transfusion hepatitis.

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A surgical case was described of a 17-year-old female with Type I of von Willebrand's disease suffering from a chronic cystic hematoma on the left thigh. The cystic hematoma was developed during these 2 years without direct traumatic episodes and attained to a fist size. The hemostatic tests revealed that Duke bleeding time 31/2min., factor VIII procoagulant activity (VIII:C) 34%, factor VIII related antigen (VIIIR:AG) 25% and ristocetin cofactor activity (VIIIR:RC) 16%. Immediately before surgery, she was given DDAVP (0.4μg/kg) and tranexamic acid (0.75g a day). One hour after DDAVP infusion, levels of VIII:C, VIIIR:AG and VIIIR:RC increased to 78, 40 and 48%, respectively. These values returned to the preinfusion levels after 12 hours. Further infusions of DDAVP were given every 12 hours for 2 days and every 24 hours for the following 3 days. After each infusion of DDAVP, there was 2-3 fold increase of factor VIII-related activities.
The operation and the early postoperative course went on uneventfully, though a coin-sized ecchymosis appeared around the operation wound on 5th postoperative day. On the 9th postoperative day, the removal of the sutures was performed by an additional dose DDAVP without abnormal bleeding. During the course of DDAVP infusions, these was no significant side effect except a transient facial flushing.

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We recently came across anti-Do^a in a patients' serum who had been pregnant and transfused.
The anti-Do^a was best detected by the indirect antiglobulin test with enzeme-treated red cells.
Testing bloods from 120 donors, we found 20 Do(a+) samples (16.7%).
The phenotype Do(a+b-) had not yet been detected in Japanese population. Testing the above 20 Do(a+) donors with anti-Do^b, we found 2 Do(a+b-) donors (1.7%).

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