Abstract
RATIONALE: In this province, ensuring hepatitis E virus (HEV)-free blood products is imperative. Monitoring HEV antibodies in symptomatic patients with abnormal liver function is key to preventing transfusion-induced hepatitis. PATIENT CONCERNS: A 34-year-old female had a sudden cardiopulmonary arrest, treated with cardiopulmonary resuscitation, defibrillation, and extracorporeal membrane oxygenation (ECMO). She was discharged but developed liver dysfunction 15 days postsurgery, with positive HEV-IgM. DIAGNOSES: She was diagnosed with HEV infection. Considering her critical postresuscitation status during ECMO support, the blood transfusion received at that time is highly suspected as the potential route of HEV transmission. INTERVENTIONS: The patient received immediate treatment with Baojians, a hepatoprotective agent, to reduce elevated liver enzymes. Serial monitoring of her liver function was conducted, including regular assessments of aminotransferases, bilirubin, and coagulation parameters. Additionally, a detailed review of her transfusion history was performed to identify potential sources of HEV exposure, such as previous blood product transfusions or organ transplants. OUTCOMES: The patient achieved complete recovery, with liver function parameters returning to normal ranges. This outcome not only validated the effectiveness of the implemented treatment regimen but also underscored the significant risk of HEV transmission via blood transfusion. LESSONS: Blood transfusions in ECMO rescue enhance coagulation and manage anemia, but they also pose risks associated with transfusions. Among these, acute jaundice hepatitis E caused by blood transfusion requires our special attention. To reduce the incidence of hepatitis E from blood transfusions, it is advisable to incorporate hepatitis E antibody monitoring into blood product testing.