3-16. HEPATITIS-IMPLICATED DONORS AND THOSE FOUND TO HAVE
HEPATITIS B SURFACE ANTIGEN OR HEPATITIS C VIRUS
a. When a donor is implicated in a case of hepatitis, he should be recalled (see
figure 3-4) and re-questioned in depth.
b. A blood sample should be drawn and examined for bilirubin, serum alanine
aminotransferase (SGPT), HBsAg, and HCV. Abnormal results in any of these tests
may exclude the donor from future donations. When hepatitis develops after exposure
to multiple units of blood and/or blood components, it is not necessary to exclude all of
the involved donors; but they should be noted as having been implicated once. A donor
implicated in a 1-unit transfusion or a donor implicated in more than one case of post-
transfusion hepatitis involving multiple units should be permanently excluded from future
donation (see figure 3-5).
c. The excluded donor and the HBsAg-positive donor should be notified by the
Medical Director of the blood bank by a letter (see sample letters), but personal contact
prior to this is strongly recommended. The donor must be made clearly aware that he is
exempted from future blood donations and that he has a potentially hazardous
condition, but this should be handled with concern and tact. A repeat donor
examination, follow-up laboratory tests, and personal discussion with the donor and his
physician would constitute optimal management of persons who have been willing blood
donors, but now must be permanently excluded from donating blood.
3-17. USE OF GAMMA GLOBULIN WITH TRANSFUSIONS
The routine administration of gamma globulin as either immune serum globulin
(lSG) or hepatitis B immune globulin (HBlG) in all transfused patients to prevent viral
hepatitis is not recommended. For patients accidentally exposed to blood products
which are found in retrospect to be HBsAg positive, the use of lSG or HBlG should be
3-18. LABORATORY SAFETY
In handling any human blood specimen, personnel must be aware of the possible
risk of infection with hepatitis viruses. It is recommended that routine precautions be
taken to protect the health of laboratory personnel. These include:
There should be no eating, drinking, or smoking in the laboratory.
Mouth pipetting is to be forbidden.
Personnel with open cuts or sores on their hands must not do HBsAg
testing and must wear disposable gloves when handling specimens.