Human Albumin Infusions and Homologous Serum Jaundice

Paine, Richmond S.

doi:10.1001/jama.1952.03680030031009

Cited by 22 publications

(4 citation statements)

References 31 publications

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“…None of the patients had a previous history of hepatitis. None had a history of biliary disease except one (case 8, table 1 ). No blood donor gave blood to more than one of these persons with hepatitis.…”

Section: Resultsmentioning

confidence: 99%

“…For example, 25 of these lots were given to only one patient each. Nevertheless, table 1 shows that in plasma recipients in whom serum hepatitis developed, a minimum of seven lots were involved (if all 10 cases were acquired through this mechanism). Attempts were made to study the experience elsewhere in the United States with other units of these same seven lots of plasma, but barriers to adequate follow-up prevented further investigation.…”

Section: Resultsmentioning

confidence: 99%

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Serum Hepatitis Apparently Acquired From Irradiated Plasma

Albrecht¹

1953

JAMA

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tion of the agent of homologous serum hepatitis. Trans¬ fusion of pooled dried plasma, even though irradiated, I 1 Patients Investigated 1 Patients with Hepatitis B Deaths IO 20 33 38 38 AGE BY DECADE 24 26 12 Incidence of hepatitis and deaths by age groups.involves a calculated risk that should be considered care¬ fully in relation to the need of the patient for this thera¬ peutic agent. SUMMARY AND CONCLUSIONSFour hundred and sixty-four records of patients who had received pooled, dried irradiated human plasma 150 or more days previously were investigated. The records of 180 patients were found adequate to warrant a study of the occurrence of serum hepatitis as a result of the plasma transfusion. Twenty-three or 12.8% of the 180 patients had signs and symptoms of serum hepatitis. Seven or 30.5% had died as a direct result of the disease or a combination of their original disease and the hepa¬ titis. Of 64 patients who had received only plasma and no whole blood, 6(9.3%) had hepatitis. The occurrence of a 12.8% incidence of hepatitis is considered signifi¬ cantly higher than that of hepatitis as the result of blood transfusion alone (0.5% ) or the incidence of infectious hepatitis (0.02% ). The findings indicate that the meth¬ ods now used for the irradiation of pooled plasma in large-scale production are not wholly effective in com¬ plete destruction of the agent of homologous serum hepatitis.7. Henle, G.; Drake, M. E.; Henle, W.Pooled human plasma, untreated, has been a frequent cause of serum hepatitis. Blood from one donor carrying the virus can make a whole pool infectious. Obviously the likelihood of plasma being infected varies with the number of donors making up the pool. Plasma from a large pool is more frequently infected than plasma from a small pool. The probability of contracting serum hepatitis from a whole blood transfusion is extremely small. Paine and Janeway1 have analyzed reports on this subject.Exposing plasma to ultraviolet light seemed to obviate this hazard. Known icterogenic serum so treated has been given in small quantities to volunteers without causing hepatitis.2 MacCallum,3 on the other hand, used a different technique of irradiation that failed to prevent the transmission of hepatitis. Irradiation of plasma has been required by the National Institutes of Health since April, 1949, as a prerequisite to licensing manufacturers.That irradiation does not always inactivate the virus was shown by James, Korns, and Wright4 who reported the occurrence of 12 cases of serum hepatitis among 20 recipients of one lot of irradiated plasma. Of course this outbreak could have been due to faulty irradiation of the plasma involved, rather than to the inefficacy of ir¬ radiation as a means of inactivating hepatitis virus. There have been other reports 5 attributing serum hepatitis to irradiated plasma, but this apparent association could have been coincidental rather than causal. To pursue this problem further, a series of patients who received irradiated plasma from several sources was studied to dete...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Serum Hepatitis Apparently Acquired From Irradiated Plasma

Albrecht¹

1953

JAMA

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“…In a study conducted in 1952 by Paine and Janeway, 3 237 albumin recipients (receiving albumin from 92 production lots) were prospectively followed to determine the prevalence of hepatitis. The high prevalence of hepatitis in the donor population, combined with the effects of pooling, led to an expectation that jaundice would be observed in 39 percent of recipients.…”

Section: Albuminmentioning

confidence: 99%

“…Of the 33 recipients who received only albumin, however, none developed jaundice. Of the 204 who had received other blood products as well as albumin, only 2 (1%) developed jaundice 3 …”

Section: Albuminmentioning

confidence: 99%

The epidemiology of virus transmission by plasma derivatives: clinical studies verifying the lack of transmission of hepatitis B and C viruses and HIV type 1

Tabor

1999

Transfusion

118

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During the past 50 years, most US-licensed plasma derivatives have maintained an impressive record of not transmitting HBV, HCV, or HIV Albumin (50-year history) has never transmitted these viruses. PPF (40-year history) transmitted HBV on only one occasion, which was associated with a design flaw in one manufacturing plant. IGIM has never transmitted any of these viruses since the requirement of sensitive serologic screening tests for HBV (24 years). IGIV (17-year history) transmitted HCV in only one outbreak involving the product of one manufacturer. Even AHF and FIX have not transmitted these viruses since effective virus-inactivation processes in manufacturing were developed. In summary, there has been no transmission of HBV, HCV, or HIV by US-licensed plasma derivatives since the introduction of effective virus-inactivation procedures. This means, essentially, that there has been no transmission of these viruses since the end of 1987; the sole exception is IGIV, by which there has been no transmission since 1994.

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Human Thrombin as Vehicle of Infection in Homologous Serum Hepatitis

Porter¹

1953

JAMA

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Human Albumin Infusions and Homologous Serum Jaundice

Cited by 22 publications

References 31 publications

Serum Hepatitis Apparently Acquired From Irradiated Plasma

Serum Hepatitis Apparently Acquired From Irradiated Plasma

The epidemiology of virus transmission by plasma derivatives: clinical studies verifying the lack of transmission of hepatitis B and C viruses and HIV type 1

Human Thrombin as Vehicle of Infection in Homologous Serum Hepatitis

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