Reducing the risk of transfusion‐transmitted cytomegalovirus infection: a systematic review and meta‐analysis

Mainou, Maria; Alahdab, Fares; Tobian, Aaron A.R.; Asi, Noor; Mohammed, Khaled; Murad, M. Hassan; Grossman, Brenda J.

doi:10.1111/trf.13478

Cited by 31 publications

(21 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…25 Small studies in select patient populations have suggested that additional provision of CMV seronegativity may be unnecessary. [22][23][24] Fewer studies 7,26 support the contrasting view that CMV seronegativity may be required to minimize TT-CMV risk from leukoreduced blood.…”

Section: Discussionmentioning

confidence: 99%

“…All of these studies involve specific high-risk populations (HPC transplant recipients) and have difficulty confirming TT-CMV because the source of CMV infection can be from multiple routes. 25 Further, these studies often fail to address the role of prophylactic treatment or viremic monitoring in prevention of CMV disease.…”

Section: Discussionmentioning

confidence: 99%

“…Importantly, in this study all cases of neonatal CMV were secondary to breast milk rather than transfusion. 25,29 Transplant patients are also at high risk for CMV disease; however, most institutions surveyed indicated no established policy to provide CMV-seronegative products to transplant patients. That these facilities do not specify a requirement for the provision of CMV-seronegative products reflects the available evidence-based literature, which indicates equivalence of leukoreduced compared to CMVseronegative products for prevention of TT-CMV in HPC transplant recipients.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Survey on Transfusion-Transmitted Cytomegalovirus and Cytomegalovirus Disease Mitigation

Weisberg¹,

Staley²,

Williams³

et al. 2017

Archives of Pathology &Amp; Laboratory Medicine

View full text Add to dashboard Cite

Context.— Cytomegalovirus (CMV) can be transmitted by cellular blood products, leading to severe disease in immunosuppressed patients such as neonates and transplant recipients. To mitigate transfusion-transmitted CMV (TT-CMV), “CMV-safe” blood products (leukoreduced and/or CMV-seronegative) are transfused. Attempts to develop practice guidelines for TT-CMV mitigation have been limited by paucity of high-quality clinical trials. Objective.— To assess current TT-CMV mitigation strategies across medical institutions for specific at-risk populations. Design.— Supplemental questions regarding TT-CMV and CMV disease mitigation were added to a College of American Pathologists Transfusion Medicine (Comprehensive) Participant Survey in 2015, addressing whether a given institution provided CMV-safe products for 6 at-risk patient populations. Results.— Ninety percent (2712 of 3032) of institutions reported providing universally leukoreduced blood products. Among institutions without universal leukoreduction, 92% (295 of 320) provided leukoreduced products on the basis of clinical criteria. Eighty-three percent (2481 of 3004) of respondents reported having availability of CMV-seronegative products; however, wide variation in policies was reported governing CMV-seronegative product use. Among all respondents, less than 5% reported using CMV prophylaxis and monitoring in high-risk patient groups. Transplant centers reported higher rates of CMV prophylaxis (25% [97 of 394] solid organ) and monitoring (15% [59 of 394] solid organ) for CMV-negative transplant recipients. Conclusions.— Universal leukoreduction is the primary strategy for mitigating TT-CMV. While most institutions have both CMV-seronegative and leukoreduced blood products available, consensus is lacking on which patients should receive these products. High-quality studies are needed to determine if CMV-seronegative and leukoreduced blood products are needed in high-risk patient populations.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Survey on Transfusion-Transmitted Cytomegalovirus and Cytomegalovirus Disease Mitigation

Weisberg¹,

Staley²,

Williams³

et al. 2017

Archives of Pathology &Amp; Laboratory Medicine

View full text Add to dashboard Cite

show abstract

“…Auch nach Einführung der generellen Leukozytendepletion wurden in 1 bis 3 % der Transfusionsempfänger HCMV-Infektionen beschrieben [119]. Eine Metaanalyse der wenigen, oft Jahre zurückliegenden Studien zeigte keine Vorteile der HCMVAntikörpertestung gegenüber der Leukozytendepletion oder der Kombination aus beiden Strategien [52,120]. In aktuellen Studien wird das Risiko einer transfusionsassoziierten Infektion nach Gabe von nicht auf HCMV-Antikörper untersuchten, leukozytendepletierten Blutkomponenten mit unter 1: 1.000.000 angegeben [121,122] …”

Section: üBertragbarkeitunclassified

Humanes Cytomegalievirus (HCMV)

2017

Bundesgesundheitsbl

View full text Add to dashboard Cite

“…33-3.18). 56 Although these studies are few in number with a high degree of uncertainty in the calculated RRs, there is no current evidence that LR/CMV-seronegative blood products are superior to LR-only blood products in the prevention of TT-CMV infection in HSCT patients. Until there is evidence to the contrary, the "belt-and-suspenders" approach in HSCT patients is not warranted, especially given the added expense and difficulty in maintaining an adequate CMV-seronegative blood supply.…”

mentioning

confidence: 99%

Current strategies and future directions for the prevention of transfusion-transmitted cytomegalovirus

Harmon¹,

Cooling²

2017

IJCTM

View full text Add to dashboard Cite

Cytomegalovirus (CMV) is a pervasive DNA virus that infects a significant portion of individuals worldwide, and may be transmitted through the transfusion of blood products. Although CMV infection is of little consequence in immunocompetent individuals, patients with an impaired immune system are at risk of significant morbidity and mortality. Unlike other blood-borne infectious agents, it is impractical to defer all CMV-positive individuals from blood donation as this would exclude a substantial number of otherwise eligible donors. Other methods such as transfusion of CMV-seronegative and leukoreduced blood products must be employed to prevent the transmission of CMV to at-risk patients. In this study, the widespread use of current strategies for the prevention of transfusion-transmitted CMV (TT-CMV) infection and the evidence to support these methods in various at-risk groups were reviewed. In addition, emerging pathogen inactivation technologies that have the potential to eliminate TT-CMV were also discussed.

show abstract

Reducing the risk of transfusion‐transmitted cytomegalovirus infection: a systematic review and meta‐analysis

Abstract: At present, the scientific evidence does not favor a single strategy for reducing the risk of transfusion-related CMV infection in high-risk patients.

Cited by 31 publications

References 21 publications

Survey on Transfusion-Transmitted Cytomegalovirus and Cytomegalovirus Disease Mitigation

Survey on Transfusion-Transmitted Cytomegalovirus and Cytomegalovirus Disease Mitigation

Humanes Cytomegalievirus (HCMV)

Current strategies and future directions for the prevention of transfusion-transmitted cytomegalovirus

Contact Info

Product

Resources

About