A unit of autologous blood tested repeatedly reactive for HBsAg. What action should be taken?

When a unit of autologous blood tests repeatedly reactive for HBsAg (Hepatitis B Surface Antigen), it indicates that there is a potential for Hepatitis B infection in the individual who donated the blood. In this situation, the unit cannot be used for allogeneic (donor-to-patient) transfusions; however, the patient's autologous blood could still potentially be utilized under certain conditions.

Choosing to obtain a written request from the patient's physician and sending the unit with a biohazard label and "autologous use only" is appropriate as it ensures that the use of the blood is strictly controlled and that the physician is aware of the potential risks associated with using this unit. This process provides a legal record and enforces that the decision for use is made with all necessary information about the donor's health status.

It is essential to label the unit correctly to highlight the risk of Hepatitis B transmission and to indicate that it is intended only for the person who donated it, thus minimizing risk to other patients. This procedure balances safety with the patient's needs, allowing for the use of their own blood while ensuring that healthcare providers are aware of the risks involved.