Use of a table-top analyzer for predonation screening for alanine aminotransferase--a cost-effective approach?

To reduce the transmission of non-A-non-B hepatitis, the American Association of Blood Banks has required that all blood donations with alanine aminotransferase (ALT) levels above a certain cut-off level to be discarded. This discard rate resulting from high ALT levels was 5.3% at the authors' donor center, which was more than double the expected rate of 2.3%. If blood donors could be tested for their ALT levels before blood donation, unnecessary discarding of blood and related expenses could be eliminated. Therefore, the authors evaluated a table-top ALT analyzer for screening donors before blood donation. The method was precise and linear and correlated well with the SMAC-II analyzer. Based on a cost-savings analysis, the authors found it to be financially beneficial to perform predonation ALT testing. Because the cost of labor and reagents may vary from institution to institution, however, other facilities should perform their own cost-savings analyses before implementing predonation ALT testing.