Survey of current practice for prevention of transfusion-transmitted cytomegalovirus in the United States: leucoreduction vs. cytomegalovirus-seronegative

Smith, D.J.; Lu, Qi; Yuan, Shauna H.; Goldfinger, Dennis; Fernando, Leonor P; Ziman, Alyssa

doi:10.1111/j.1423-0410.2009.01228.x

Cited by 42 publications

(26 citation statements)

References 26 publications

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“…The lack of accepted practice by neonatologists and transfusion medicine specialists has led to variation in center‐specific policies for transfusion of neonatal patients throughout the United States. In a survey of 183 American centers that ranged from academic to community hospitals, blood centers and governmental or military facilities, approximately 38% use CMV‐NEG only, 23% use LR only, 15% use either, 24% use LR when CMV‐NEG is not available, and 22% of centers use CMV‐NEG plus LR in preterm infants …”

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confidence: 99%

“…In a survey of 183 American centers that ranged from academic to community hospitals, blood centers and governmental or military facilities, approximately 38% use CMV-NEG only, 23% use LR only, 15% use either, 24% use LR when CMV-NEG is not available, and 22% of centers use CMV-NEG plus LR in preterm infants. 8 Breakthrough infection in recipients has been demonstrated with both the CMV-NEG-only and LR-only transfusion, although the reasons for the residual infectivity are distinct. 6 In the CMV-NEG transfusion approach, the window period is the most likely reason for breakthrough infections.…”

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Postnatal cytomegalovirus infection: a pilot comparative effectiveness study of transfusion safety using leukoreduced‐only transfusion strategy

et al. 2016

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BACKGROUND The optimal mitigation strategy to prevent transfusion transmission of cytomegalovirus (TT-CMV) in preterm very low birthweight infants remains debated. Hospitals caring for this patient population have varied practices. STUDY DESIGN AND METHODS A prospective observational comparative effectiveness pilot study was conducted to determine the feasibility for a larger study. The pilot was carried out at hospitals using a leukoreduction (LR)-only transfusion strategy. Specimen and data collection for this study was performed in a similar approach to a study completed at Emory University that employed the CMV-seronegative plus LR approach. All testing was performed at one laboratory. The rates of TT-CMV using the two transfusion strategies were compared. RESULTS Zero incidence of TT-CMV was detected in infants (n = 20) transfused with LR-only blood (0/8; 95% confidence interval [CI], 0-25.3%) and is consistent with the previously reported zero incidence of TT-CMV finding in a cohort of infants transfused with CMV-negative plus LR blood (0/310; 95% CI, 0%–0.9%). The seroprevalence rate among enrolled mothers (n = 17) was 60%. Forty percent of those infants (8/20) received 43 transfusions; five were transfused with one or more CMV-seropositive blood components. One infant had tested positive for CMV before receiving blood transfusions; the infant’s mother was CMV immunoglobulin (Ig)G positive and IgM negative. CONCLUSIONS Using the LR-only transfusion approach, zero cases of TT-CMV were detected in this pilot study. A larger study is needed to reliably determine the most effective strategy for prevention of TT-CMV in this population.

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Postnatal cytomegalovirus infection: a pilot comparative effectiveness study of transfusion safety using leukoreduced‐only transfusion strategy

et al. 2016

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“…Thus, leukoreduced blood components have been advocated as an alternative to transfusion for patients at risk for CMV when seronegative blood is unavailable, although whether leukoreduced blood is as safe as seronegative blood in terms of TT-CMV risk remains a matter of debate. [2][3][4][5] Breakthrough cases have been attributed to transfusion with CMV-seronegative, but CMV DNA-positive blood that might have been donated during a window period, namely, the preseroconversion viremic phase of acute infection. 6 This could justify using leukoreduced blood to avoid transfusion with blood obtained during window periods that serologic screening could miss.…”

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Cytomegalovirus (CMV) seroprevalence in Japanese blood donors and high detection frequency of CMV DNA in elderly donors

et al. 2013

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The seroprevalence of CMV among Japanese blood donors of child-bearing age has not changed over the past 15 years. Latent CMV becomes reactivated more frequently among elderly donors than among younger donors. A proportion of them have free CMV DNA in their plasma fraction, which could not be diminished by leukoreduction. The risk of transfusion-transmitted CMV infection in blood with plasma CMV DNA should be determined.

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“…80,81 However, a survey of AABB physician members showed wide variability in transfusion practice. 82 Since then, 2 additional studies have been published with results that support the safety of using leukoreduced blood alone for the prevention of transfusion-transmitted CMV infection. 83,84 These studies focused on transfusion and transmission in patients receiving allogeneic HSCT.…”

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Transfusion Support Issues in Hematopoietic Stem Cell Transplantation

Cohn

2015

Cancer Control

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on canvas printed with an image of myxofibrosarcoma with metastases to the artist's lung, 26" × 36". Minnesota, Minneapolis, Minnesota. Submitted March 27, 2014; accepted July 23, 2014. Address correspondence to Claudia S. Cohn, MD, PhD, D242 Mayo Memorial Building, MMC 609, 420 Delaware Street, South East, Minneapolis, MN 55455. E-mail: cscohn@umn antigen (HLA) matching remains an important predictor of success with HSCT; however, the ABO barrier is often crossed when searching for the most appropriate HLA match between donor and patient. Crossing the ABO barrier has little or no effect on overall outcomes; however, complications can arise due to antigenic incompatibility between the transplanted cells and the patient. From the Department of Laboratory Medicine and Pathology, University of1 This review will discuss the transfusion support of patients receiving HSCT, common transfusion-related complications that health care professionals will likely encounter, and the measures required to safely deliver blood components.HSCTs can be broadly divided into related allogeneic, unrelated allogeneic, and autologous transplantation. Hematopoietic progenitor cells (HPCs) for allogeneic transplantation come from 3 sources: apheresis-derived, mobilized peripheral blood pro- Transfusion Support Issues in Hematopoietic Stem Cell Transplantation

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Survey of current practice for prevention of transfusion-transmitted cytomegalovirus in the United States: leucoreduction vs. cytomegalovirus-seronegative

Abstract: There is wide variability in transfusion practices to reduce the risk of TT-CMV. Lack of a consensus approach may reflect the conflicting data that exist in the literature as well as adherence to longstanding practice.

Cited by 42 publications

References 26 publications

Postnatal cytomegalovirus infection: a pilot comparative effectiveness study of transfusion safety using leukoreduced‐only transfusion strategy

Postnatal cytomegalovirus infection: a pilot comparative effectiveness study of transfusion safety using leukoreduced‐only transfusion strategy

Cytomegalovirus (CMV) seroprevalence in Japanese blood donors and high detection frequency of CMV DNA in elderly donors

Transfusion Support Issues in Hematopoietic Stem Cell Transplantation

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