A novel DNA virus, TT-virus (TTV), has been reported in patients with non-A-G posttransfusion hepatitis in Japan. We sought to determine whether TTV infection occurs in North American blood donors and to further determine the prevalence of TTV infection in several groups of patients with liver disease, including patients with cryptogenic cirrhosis and idiopathic fulminant hepatic failure. TTV infection was sought by detection of TTV DNA in serum by polymerase chain reaction (PCR) using primers generated from a conserved region of the TTV genome. Blood donors, patients with cryptogenic cirrhosis, idiopathic fulminant hepatic failure, and patients with other forms of advanced liver disease with and without a history of parenteral exposures were studied. TTV infection was present in 1% (1 of 100) of blood donors, 15% (5 of 33) of patients with cryptogenic cirrhosis, 27% (3 of 11) of patients with idiopathic fulminant hepatic failure, 18% (2 of 11) of patients with a history of exposure to blood products, and 4% (1 of 25) of patients without parenteral risk factors. For all patients tested, a history of prior exposure to blood products was associated with an increased risk of TTV infection (relative risk, 4.5; 90% confidence intervals, 0.6-43.9). We conclude that TTV infection is present among North American blood donors and is common in patients with liver disease, including cryptogenic cirrhosis and fulminant hepatic failure. Further studies are required to determine the role of TTV in the pathogenicity of acute and/or chronic liver disease. (HEPATOLOGY 1998;28:839-842

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6 renal transplant patients, seen at the Mayo Clinic between July 1982 and April 1983, received Minnesota antilymphoblast globulin (MALG) for treatment of allograft rejection and demonstrated warm-acting ‘auto’-antibodies during such therapy. These antibodies represented xenogeneic reactivity in equine MALG, rather than the products of patient-derived immune responses, since they were not detected before or after the period of therapy with this immunosuppressive agent in any of the 6 cases. They interfered with crossmatch procedures for red cell transfusion, and were only variably removed by autoabsorption techniques. Heat treatment of sera containing MALG-related red cell antibodies was ineffective in abrogating their reactivity and also compromised the reactivity of some red cell alloantibodies which were tested as controls. Transfusion of ‘least-incompatible’ red blood cells had no adverse effects in 2 cases where it was necessitated by clinical circumstances, despite an inability to obtain suitable serological samples for crossmatching