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[How healthy are our blood donors? Result of a liver screening in voluntary blood donors of Blutspendedienst Innsbruck].

A screening of hepatic function and HBs-antigen, made in 22344 voluntary blood donors in the bloodbank of Innsbruck, gave the following results: 0,33% HBs-AG negative donors were found to have pathological liverfunctiontests. Overweight and alcohol would be established as the most important etiological factors. 0,4% of the donors are carriers of the HBs-antigen. A control examination after 2 years showed a persistence of that antigenemia. Antigen carriers are requested to have regular examinations. Since HBs-AG positive hepatitis is not only transferred by blood and blood-constituents, it would be important to use the same screening methods applied in the blood donor organisation throughout any hospital area, to reduce the incidence of this disease.

Alcoholism

Cellular and plasma-associated phagocytic defects amongst Iranian blood donors.

Peripheral blood leucocytes from 30 grossly anaemic professional blood donors were investigated for phagocytosis, intracellular killing and chemotaxis. The nitro-blue tetrazolium test was positive in 29 donors and negative in 1. Professional donors' cells in the presence of normal plasma were unable to phagocytose successfully and Candida killing and opsonization were defective when donors' plasma was used in the presence of normal cells. Chemotaxis of professional donors' cells to Ag/Ab-treated normal plasma was reduced as was chemotactic activity of normal cells in both Ag/Ab- and LPS-treated professional donors' plasma.

Anemia, Hypochromic

[Incidence of hepatitis surface antigen among all the blood donors of the blood banks of the Venezuelan Institute of Social Security in the federal district].

The presence of H Bs-Ag was studied by means of counterimmunoelectrophoresis in the sera of 879 voluntary donors who gave blood between May and September 1974 at the federal District's blood banks of the Venezuelan Institute of Social Security. Eight hundred twenty-eight were male and fifty one female. Five sera samples were positive HBs-Ag which represents an incidence of 0.56%. A bibliographic review of the subject is made. The necessity of making mandatory the determination of HBs-Ag in all blood prior to transfusion is emphasized.

Adolescent

[Hepatologic dispensaire for blood donors].

By means of hepatological examinations of 119 blood donors who became conspicuous by liver screenings in 57 cases we could prove an adipose degeneration without, in 16 cases a fatty degeneration of the liver without, in 9 cases an adipose degeneration with and in 15 cases a fatty degeneration of the liver with mesenchymal reaction. Only 9 blood donors had normal liver findings. 90% of the punctured blood donors had an overweight up to a maximum of 35 kg in comparison to the ideal weight. 30% of the punctured patients admitted a clearly increased daily consumption of alcoholic beverages. By means of repeated punctures on 24 blood donors after 8 to 32 months after an adequate consultation in three cases a normalisation and in eight cases an improvement of the liver findings could be proved. In 13 cases the findings remained unchanged, also the anamnestic and clinical findings corresponded to this. In 2 blood donors by means of a threefold liver puncture in the observation period of 48 months also a clear retrogression of the liver findings was proved. With this was also connected the reduction of overweight and the avoiding of alcohol. Thus our investigations confirmed that overweight and abuse of alcohol are essential factors for the development of a fatty degeneration of the liver. Of an infectious hepatitis reported in the anamnesis in 10 blood donors histologically in no case residues were established. Thus the liver dispensary is of great importance for the care of blood donors who become conspicuous by screening tests. On the one hand the importance is referred to the blood donor himself, on the other hand to the group of donors. Blood donors taken out of the group could again be included in the special group, when after the exclusion of known noxae the retrogression of unspecific liver changes took place.

Adolescent

[Preventive-medicine screening methods in the examination of blood donors].

From a blood transfusion service with ca. 7000 donors a year, there was a loss of donors whose blood, having undergone medical tests, was found to be unsuitable. Details of all such donors were carefully documented. The results were ascertained by attentive control of the health of the donors which, in part, exceeded the minimum requirements laid down by the existing regulations. The relatively high loss of donors and the kind of disease underline the importance of these control checks, as an aspect of preventive medicine. This is of particular importance with regard to the results of so-called "new donors", who register for the first time. They had to undergo examination, and were only allowed to give blood when all the results of the tests had been submitted. The question then arises as to whether the regulations for the differing minimum requirements for the examination of "occasional donors" and "regular donors" can be maintained. A reduction of the expenditure on the present regulation examination of donors is not advocated because of both responsibility towards the blood donors, and in view of the increasing significance, to the medical care of patients, of the proximity of a clinic to an expedient transfusion service.

Anemia, Hypochromic

The prevalence of hepatitis B surface antigen and its antibody in blood donors and high risk groups in Iran.

The prevalence of HBsAg and anti-HBs among voluntary blood donors, professional blood donors, INBTS laboratory staff, haemophiliacs and the patients and medical personnel of three haemodialysis centres was compared. The 3.4% incidence of HBsAg found among 168,890 voluntary donors was significantly less than the 8.4% found among 378 professional blood donors. The prevalence of HBsAg was higher in male than in female donors, and also higher in single than in married donors. Prevalence of HBsAg was unrelated to ABO-Rh blood group but was related to age. Anti-HBs was found in 30% of voluntary blood donors, 67% of professional donors, 68% of haemodialysis patients, 39% of haemodialysis staff, 86% of haemophiliacs and in only 4.8% of HBsAg carriers. Subtyping of HBsAg found in 100 voluntary donors showed 65 were ay; 5 ad; 10 ad + ay and 20 were untypable.

Adult

Cytomegalovirus infection in a volunteer blood donor population.

Among 223 volunteer blood donors who were studied for evidence of cytomegalovirus (CMV) infection, 58 percent had complement-fixing antibody and 59 percent had indirect hemagglutinating antibody to CMV. No virus was isolated from any donor's washed leukocytes or leukocyte-rich plasma in fibroblast monolayer culture. In seven asymptomatic donors (3 percent), CMV was recovered from urine cultures obtained at the time of blood donation. However, at the time of reexamination, viruria was no longer present and serum antibody titers had not changed. In the three patients studied who received blood from three of the cytomegaloviruric donors, serological evidence of CMV infection developed (fourfold or greater indirect hemagglutinating antibody rise), and one recipient also developed cytomegaloviruria; no illnesses was associated with these infections. Further study is needed to establish that the detection of viruria in donors may identify potentially infective blood.

Antibodies, Viral

Trials of rosette test application for determination of immune response to antigen D from the Rh system in blood donors immunized with human erythrocytes.

Periodic control examinations of Rh-negative blood donors sensitized with human Rh-positive erythrocytes were performed to establish the differences in the levels of T and B lymphocytes and their correlation with the production of anti-Rh D antibodies. The investigations were carried out on 10 healthy blood donors in the initial period of immunization and 8 blood donors who had received multiple injections of these erythrocytes and who were producing anti-Rh antibodies. The control group included 10 non-immunized blood donors. The percentage of T and B lymphocytes was calculated on the basis of the rosette tests (E, EA, EAC) while the level of antibodies produced in serum was determined by serological methods. During immunization of blood donors no significant differences were observed in the level of T lymphocytes, while the level of B lymphocytes increased, especially in the 3rd week after the 1st or 2nd injection of erythrocytes and this was not correlated with the production of anti-Rh D antibodies in later period.

B-Lymphocytes

Hepatitis B surface antigenaemia: incidence and significance in Zambian blood donors.

Forty-eight (5.0%) of 966 healthy Zambian blood donors were positive for hepatitis B surface antigen (HBsAg) when tested by the turkey erythrocyte passive haemagglutination (TEPHA) method. Twenty-six were investigated in detail, but only one blood donor was found to have liver disease, and this was thought unlikely to be causally related to HBsAg (alcohol-induced fatty infiltration). It is recommended however, that blood donors should be screened for HBsAg. Positive individuals should be rejected but their serum tested for aspartate transaminase (AST), and, if elevated, a liver biopsy performed. This ideal policy is not practicable in all tropical hospitals.

Adult

The induction and abolition of specific immunosuppression of heart allografts in rats by use of donor blood and cyclophosphamide.

Intravenous pretreatment of WAG/Rij rats with BN blood 14 days before transplantation leads to permanent survival of BN heart allografts. Pretreatment with donor blood in the reverse donor-host combination gives rise to accelerated rejection of WAG/Rij hearts. Addition of 100 mg/kg Cy to the pretreatment with donor blood in the WAG/Rij to BN model resulted in permanent graft acceptance, presumably due to the phenomenon of immunologic enhancement. This effect could be observed only if the interval between drug administration and antigen pretreatment was short. The use of Cy had a more profound and long-lasting effect on humoral than on cellular immunity. Addition of 100 mg/kg Cy to the active enhancement protocol in the "easy" BN to WAG/Rij combination produced permanent graft survival in an immunologic setting reminiscent of immunologic tolerance. The combined pretreatment with donor blood and 50 mg/kg Cy in this donor-host combination abolished the operation of immunologic enhancement, which could be induced if donor blood was given alone.

Animals

Hepatitis Be antigen and antibody in hepatitis B surface antigen positive blood donors.

In a study of 105 asymptomatic HBsAg positive blood donors, 9 (8.6%) were found to have HBeAg, 38 (36.2%) anti-HBe, and the remaining 58 (55.2%) neither marker detectable by gel diffusion. There was no correlation between HBeAg/anti-HBe status and HBsAg sub-types, Glm allotypes, the presence of anti-Gm, red cell antibodies, or rheumatoid factor. Rheumatoid factor activity could be removed from anti-HBe positive sera without removing anti-HBe activity, indicating that separate entities were involved. HBeAg was found only in donors under the age of 30 (P less than 0.005), while anti-HBe did not show an age-related trend. HBeAg was also found less commonly in donors of blood group A than in the total carrier population (P less than 0.05), indicating an apparent protection in carriers of group A. The blood group distribution for the 105 HBsAg positive donors was similar to that of the general population.

ABO Blood-Group System

Hepatitis B core antibody in volunteer blood donors: comparison of radioimmunoassay and indirect immunofluorescence.

The results of a pilot study on the prevalence of anti-HBc in HBsAg negative volunteer blood donors are presented. Two techniques for anti-HBc determination were compared--radioimmunoassay (RIA) and indirect immunofluorescence (IF). In a panel of 56 sera with known HBV markers, RIA was found to be significantly more sensitive than IF, and both techniques were specific. Out of 2,000 HBsAg negative blood donor sera tested by RIA, 46 (2.3%) were found positive for anti-HBc. In 24/24 sera, the specificity of the anti-HBc was confirmed. Also 37/46 (80.4%) anti-HBc positives were found positive for anti-HBs, leaving 9/2,000 (0.4%) blood donors positive only for anti-HBc. It is concluded that it would be premature to advocate the introduction of anti-HBc as a routine screening test of blood donors.

Antibodies, Viral

Cell-mediated immunity in professional and voluntary blood donors.

Cell-mediated immunity (CMI) was compared in professional and voluntary blood donors. Depressed CMI in professional donors was revealed by the presence of significantly lower numbers of positive delayed reactive hypersensitivity responses to Candida albicans, streptokinase and streptodornase, as well as a decrease in lymphoblast transformation response to phytohaemagglutinin. Furthermore, the serum protein and albumin levels in professional donors did not correlate with the depression in CMI. The blood of professional blood donors should be considered to be a poor source of therapeutic immune cell fractions.

Adult