The incidence of hepatitis following massive blood transfusions, as in heart surgery with extracorporeal circulation (ECC), led to (1) screening for Australia antigen (Au) and its corresponding antibody during the postoperative period; and (2) establishment of a correlation between the number of jaundice cases detected by inquiry, and the results of an almost systematic search for the Au antigen among blood donors.
Screening for Post-ECC Au Antigen and Antibody.—During 1970, two techniques (immunodiffusion and complement fixation) were used for testing 819 postoperative patients. Preoperative screening was possible in only 680 of these (Table).
The frequency of positive results of preoperative tests was markedly higher than that found in a control population by the same techniques (frequency among 18,931 blood donors: antigen, 5.5/1,000; antibody, 2.3 per 1,000). The source of infection among preoperative patients could not be established with any degree of certainty. Several sources, however, were considered: patients in