TRANSMISSION OF HEPATITIS-B VIRUS-INFECTION BY TRANSFUSION OF FROZEN-DEGLYCEROLIZED RED BLOOD-CELLS

Chimpanzees were used to determine the ability of prior freezing of red blood cells to prevent the transmission of Type B post-transfusion hepatitis. Four units of human whole blood were each inoculated with 106 infectious doses of hepatitis B virus. Although all units became HBsAg negative after freezing and deglycerolization, hepatitis B virus infection developed in all four chimpanzees when these units were transfused. Two of these chimpanzees had only serologic evidence of infection, including the development ment of HBsAg and antibody to both the hepatitis B surface and core antigens; in these animals, the incubation periods were prolonged (24 to 25 weeks). In contrast, the other two animals also had elevated serum glutamic pyruvic transaminase (peaks of 190 and 461 IU per liter) and had a more rapid onset. There was no hepatitis B virus infection in two nontransfused controls. Our results do not support the use of frozen red blood cells for the prevention of post-transfusion hepatitis. (N Engl J Med 298:637–642, 1978) FROZEN-deglycerolized red blood cells have many potential advantages over other red-cell products, including prolonged storage time, improved blood inventory control, maintenance of rare-donor blood, reduced risk of febrile, nonhemolytic transfusion reactions and, perhaps, reduced sensitization to histocompatibility antigens. These advantages must be balanced against the increased cost of frozen-deglycerolized red cells, the increased time necessary for their preparation and their limited shelf life once thawed. It has been reported that these cells do not transmit post-transfusion hepatitis. This statement, however, is based primarily on uncontrolled, retrospective analyses1 2 3 4 and a single prospective study5 in which the ability of frozen-deglycerolized red cells. © 1978, Massachusetts Medical Society. All rights reserved.