Specific Antibody Response after Transfusion of Australia Antigen-Positive Blood in a Patient with Liver Cirrhosis

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Abstract
Liver cirrhosis was discovered clinically in a 70-year-old man who shortly afterwards was hospitalized with oesophageal bleeding. He was transfused with 23 blood and 10 plasma units in the course of 10 days and the bleeding stopped. The blood of the first transfusion was later found to be strongly Australia antigen (Au)-positive. The temperature of the patient increased in direct connection with this transfusion, and signs of mild hepatitis developed. In a blood specimen taken 1 month after the positive transfusion a high titre of anti-Au antibodies of the IgG-type was detected. The titre decreased thereafter significantly and the signs of acute hepatitis disappeared. After a period in relatively good condition the patient died from a second bleeding. At autopsy the patient was found to have cirrhosis of the liver. The clinical, immunological and pathological findings are best explained as a secondary antigenic stimulation of a patient with chronic long incubation type of hepatitis.