輸血による血清肝炎について

In recent years there have been many cases, with increasing frequency, of serum hepatitis resulted from blood transfusion. The purpose of this study was to investigate the incidence, clinical feature, prognosis and prophylaxis of serum hepatitis followed by blood transfusion. The results obtained were as follows; 1) Incidence of serum hepatitis among the patients who had blood transfusion at local institutions in Okayama City was 3.3% in 1957 and 4.7% in 1958, on the other hand, at Okayama University Hospital in 1958 it was 5.0% in the First Surgical Division, 5.4% the Second Surgery and 5.2% OBGYN respectively. The patients with serum hepatitis had received the amount 2,600 to 1,120 cc of blood, whereas 810 to 1,120 cc in the cases who never developed serum hepatitis after blood transfusion. 2) Mean incubation period was 72.8 days ranging 19 to 180 days calculated from the date of last blood transfusion. Prodremal stage varied from 1 to 20 days, average 6.1 days, icteric stage 7 to 15 days, average 35.8 days, and convalescent stage 7 to 200 days, average 30.0 days. 3) Characteristic initial symptoms were anorexia, malaise and jaundice by which fairly number of the cases noticed the onset of the disease. Few had febrile course but low grade in most of the cases. 4) Laboratory data were obtained from the 20 cases of serum hepatitis admitted to our First Mebical Division. Serum bilirubin showed the maximum level on the 10 th day, average 13.0 mg% . No significant changes were noted in peripheral blood picture but for a slight initial monocytosis. SGO-T and SGP-T presented a elevation earlier than that of serum bilirubin, maximum on or about the 5 th day and then decreased abruptly. Serum colloidal liver function tests; in initial stage, positive Takata's reaction in 51.%, positive CCF 46% and TTT 58% were noted, but even after 100 th day Takata's reaction was positive in 25% of the cases. 5) Follow-up studies were made on 49 serum hepatitis cases discharged from our hospital with complete recovery. 69% of these had subjective symptems in some sort or another. Enlargement of the liver was noted in 20% of the cases. 33 cases were studied with special reference to liver function tests and liver biopsy. It was revealed that 43% of the cases still had impairment of liver function and that by means of liver biopsy, postnecrotic cirrhosis was found 9.1% of the cases. Therefore, the prognosis of serum hepatitis of this type was considered to be grave. 6) For the purpose of prophylaxis, 300 to 600 mg of gamma globulin was simultaneously administered on blood transfusion in 38 cases. Inspite of this, 4 cases suffered from serum hepatitis later on, and no definite prophylactic effect of gamma globulin was noted.