Report of the ad hoc committee on ALT testing *

Two recent studies’72 have shown convincingly a relationship between elevated levels of serum alanine aminotransferase (ALT) in blood donors and elevated levels of the same enzyme in the recipients of their blood. Since the elevated levels of ALT in the recipient group have been equated with the diagnosis of transfusion-associated hepatitis, it has been suggested that elimination of donors with elevated aminotransferase levels will lead to a substantial reduction of posttransfusion non-A, non-B hepatitis. While we share the desire of the entire medical community to reduce the incidence of transfusion-associated hepatitis, we believe that currently available evidence does not justify either universal testing of donor blood for ALT or the rejection of donors who have elevated levels. Therefore, at this time we do not advise routine donor testing for ALT as a means of reducing the incidence of non-A, non-B hepatitis. Furthermore, we strongly advise that any testing that is undertaken be done in a way that will increase our information concerning the significance and natural course of elevated levels of ALT in donors and its relationship to the transmission of non-A, non-B hepatitis. Some of our more salient concerns include the following: