输血与丙型肝炎因果关系鉴定及相关法律问题探讨

丙型肝炎病毒（ＨＣＶ）已成为输血后非甲非乙型肝炎的主要致病因子，但是要确定患者所感染的丙型肝炎与某次输血有必然的因果关系仍很困难。本文通过对一个案例进行研究，提出鉴定方法，即收集病人的所有住院病历，查阅病人输血前、输血后或者以后一段时间转氨酶的变化情况，尤其是伤后近期查出的转氨酶水平，基本上可代表伤前的水平。结合抗－ＨＣＶ抗体的变化，确定输血与肝炎间的因果关系。作者还结合我国法律，提出输血后感染丙型肝炎的患者可以“严格责任原则”起诉医院或者血库，医院或者血库承担举证责任，举证的内容包括其所提供血液的献血员来源合法，已作了法定的筛选检测，同时提供所有法定的记录档案，否则血库或者医院将承担败诉的民事责任。

Legal Problems and appraisal causality between blood transfusion and hepatitis C

Hepatitis C virus becomes a major etiologic virus of human non-A, non-B hepatitis following blood transfusion. But it is very difficult to detect infected hepatitis C result from blood transfusion after body injury. The paper studied a case of infected hepatitis C following blood replacement (a 45-year-old man, suffered complicated trauma involving traumatic pneumothorax and haemothorax, spleen rupture, kidney rupture, diffuse peritonitis, hemorrhage shock, given blood transfusion of 1800ml). Authors advanced appraisal methods:gathering all medical records of the patient, studying ALT and AST before and after blood transfusion. ALT tested in a short time after trauma represents basically level before. Combining with level of anti-HCV, whether there was causality between blood transfusion and infected hepatitis C was detected. Authors also discussed the patient who was infected with hepatitis C following blood transfusion may ask the hospital or the blood band to undertake civil compensation disability according to civil law of PRC. The hospital or the blood bank were held responsible for citing evidence. The contents of evidence included whether source of blood donator was legitimate, legal screening tests were done, and all legal records were provided.