Solar Ecrips 20090722 Iou Island

1
The efficacy of ALT measurement before 400mL
whole blood donation at mobile busses
Solar Ecrips 2009/07/22 Iou Island
Shoichi Inaba, Teiko Rikitake, Hiroko
Watanabe Kanagawa Red Cross Blood Center
2
Aims 180,000 whole blood units are collected
by the Kanagawa Red Cross Blood Center every
year, about 4 (7,049/184,989 3.81 in 2008) of
which must be discarded due to alanine
aminotransferase (ALT) exceeding 61 IU/L. ALT
was measured just before donation to test the
effectiveness of measurement of donations at
mobile busses, from which more than 70 of our
whole blood is collected.
Solar Ecrips 2009/07/22 1054 Yakushima Island
3
Manufacturing Rate of Whole Blood Donation in
Kanagawa
4
Materials and Methods
From June 1 to October 5, 2009, three mobile
busses carried a dry-chem ALT measuring machine
(Reflotron, Roche) (Group1). Donor blood with
ALT exceeding 61 IU/L was excluded, and the
remaining blood was measured for hemoglobin.
The number of donations and number abnormal ALT
measurements at Tokyo Blood Center, which uses
the Hitachi Autoanalizer, were used for
comparison.
Reflotron, Roche
Solar Ecrips 2009/07/22 1056 Yakushima Island
5
Materials and Methods

• The rates of ALT abnormal blood by Reflotron plus
  Hitachi and by Hitachi alone were calculated.
  Excluded from the Reflotron analysis were
• First time donors
• 2. ALT values exceeding 50 IU/L at a previous
  donation
• 3. Individuals with abnormal liver function at a
  periodic health checkup.
• The data from group 1 was compared with mobile
  busses that did not carry Reflotron (Group2) and
  with the data of seven donation rooms where
  Reflotron was introduced several years ago
  (Group3).

Solar Ecrips 2009/07/22 1058 Yakushima Iland
6
Results Of 11,712 whole
blood units collected in group 1, abnormal ALT
was found in 295 (2.64). Donation was stopped
by an abnormal Reflotron value for 183 of the 775
tests (6.83, 775/11,355). When these donations
were confirmed by Hitachi test, the discard rate
was 4.56 (518/11,355), significant by Chi-square
test (plt0.01). For Group2, 31,271 whole blood
collections were made, with abnormal ALT found in
1,164 (3.72), a significant difference from
Group1 (plt0.01). In Group3, 22,888 whole blood
collections were made, with abnormal ALT found in
414 (1.81), also significantly different from
Group1 (plt0.01). In a random sampling inspection
of 2,100 of group 3, 692 (33.0) had applied
Refrotron test.
Solar Ecrips 2009/07/22 1100 Yakushima Iland
7

Results
(June 1 Oct. 5, 2009)
P lt 0.01
Diamond Ring
8
Discussion ALT has been used as a deferral
criteria for blood donation since 1981 when it
became a surrogate marker of Non-A, Non-B
hepatitis. In 1989, an HCV marker was
discovered and a specific test was introduced for
blood screening, lessening the importance of ALT
measurement. Unfortunately, it is difficult to
stop tests once they are introduced by the
government. It is a great burden on blood
centers when they collect blood that cannot be
shipped to hospitals. In this study, ALT was
measured just before donation at mobile busses.
2009/07/21 Yakushima Iland Western Forest
9
Discussion Our results showed that we can reduce
wasted blood by more than 1, which each year
would save more than 1,000 blood bags, associated
laboratory costs, and great expense at our 30
mobile buses expenses. Our results were not as
good as those of the donation rooms, probably
because of the difference in test numbers. This
test takes several minutes, causing inconvenience
to donors who must already wait a long time. Even
so, to reduce waste we are doing our best to
implement this test at our mobile
buses. Furthermore, it should be necessary
to prepare plain
leaflet for explaining
how to manage fatty liver
10
Diamond Ring
Thank you for your attention!