Naiman J L, Sugasawara E J, Benkosky S L, Mailhot E A
American Red Cross Blood Services, Northern California Region, USA.
Transfusion. 1996 Nov-Dec;36(11-12):974-8. doi: 10.1046/j.1537-2995.1996.36111297091741.x.
In a recent quality assurance audit of component returns over a 6-month period, 9 of 81 returns were due to icteric plasma. With the sensitive, new methods used to screen donors for anemia and hepatitis, it seemed likely that the icteric discoloration reflected benign unconjugated hyperbilirubinemia (Gilbert's syndrome) in the donor, rather than liver disease or hemolysis. The donors were recalled for repeat blood study to resolve this question.
Seven of the nine donors could be reached, and they submitted blood samples for measurement of serum levels of conjugated (direct-reacting) and total bilirubin and for complete blood and reticulocyte counts.
All seven donors had mild unconjugated hyperbilirubinemia, with total bilirubin levels ranging from 1.3 to 2.8 mg per dL. None showed evidence of overt hemolysis.
All seven donors of the components with icteric plasma have Gilbert's syndrome, a benign genetic anomaly occurring in approximately 3 to 5 percent of the general population. With the sensitive screening tests for viral hepatitis used today, the presence of icteric plasma in a component suggests that the donor has Gilbert's syndrome. Policies about the acceptability of icteric components from blood donors merit reassessment.
在最近一次对6个月期间成分血返还情况的质量保证审计中，81份返还的成分血中有9份是因为血浆黄疸。由于采用了敏感的新方法来筛查献血者是否患有贫血和肝炎，黄疸变色似乎反映出献血者存在良性非结合性高胆红素血症（吉尔伯特综合征），而非肝脏疾病或溶血。召回这些献血者进行再次血液检查以解决这个问题。
9名献血者中有7名能够联系上，他们提交了血样，用于检测血清结合（直接反应）胆红素和总胆红素水平以及进行全血细胞计数和网织红细胞计数。
所有7名献血者均有轻度非结合性高胆红素血症，总胆红素水平在每分升1.3至2.8毫克之间。均未显示明显溶血迹象。
所有7名血浆黄疸成分血的献血者均患有吉尔伯特综合征，这是一种在普通人群中约3%至5%的人会出现的良性基因异常。鉴于如今使用的病毒性肝炎敏感筛查试验，成分血中出现黄疸血浆表明献血者患有吉尔伯特综合征。关于接受黄疸献血者所献成分血的政策值得重新评估。
