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Elevated ALT activity in volunteer blood donors.

By far, the most common cause of post-transfusion hepatitis (PTH) is infection with the non-A, non-B hepatitis (NANB) virus. Until very recently, no specific laboratory test existed to detect the presence of this virus in donated blood. However, a correlation has been established between high donor ALT (formerly SGPT) and recipient PTH and between positive donor core antibody and recipient PTH. To lower the current high incidence of NANB-induced PTH, in 1986, the American Association of Blood Banks (AABB) recommended testing for these PTH-associated "surrogate" markers on all donated units of blood. Accordingly, testing for Hepatitis B core antibody and for ALT activity were implemented. This practice produced large amounts of data on populational ALT activity levels and core antibody positivity. The ALT activity of 3108 healthy volunteer blood donors as recorded in the donor files of the Hospital Universitario Ramón Ruiz Arnau Blood Bank were analyzed retrospectively to determine what the local normal ALT activity was. It was determined that the average ALT was 35.91 units/liter. This average is much higher than averages reported by other blood banks in the literature. Possible causes of the high local ALT activity levels are discussed.