Parenterally Transmitted Hepatitis A Associated with Platelet Transfusions

Abstract

During 3 months, nine patients with a marrow transplant hospitalized in a leukemia research center and six donor-members of their families developed acute hepatitis. Serum glutamic-oxalacetic transaminase (SGOT) screening showed 21 subclinical cases among other family members, staff members, and other donors at the center. Epidemiologic investigation implicated platelet and plasma donation and platelet transfusion as the source of exposure. Twenty-six of 29 (90%) platelet and plasma donors and 9 of 13 (69%) patients receiving platelet transfusions during the period of risk developed clinical or biochemical evidence of acute hepatitis. The clinical illness, incubation period of 27 days, and results of serologic tests were compatible with hepatitis A. Observation of the platelet donation procedure showed practices possibly responsible for the contamination of blood products. This outbreak illustrates the risk of hepatitis for platelet and plasma donors and recipients and suggests the need for reexamination of platelet and plasma donation procedures in other institutions.