The Incidence and Consequences of Cytomegalovirus Transmission via Blood Transfusion to Low Birth Weight, Premature Infants in North East Scotland

Abstract

In a 2-year study involving 133 premature low birth weight (less than 1,500 g) infants, the impact of CMV infection via blood transfusion was assessed. 8.4% (7 out of 83) of transfused infants and 10% (7 out of 70) of those exposed to seropositive blood acquired CMV. In those less than 1,250 g the infection rate rose to 13.2% (7 out of 46). Seropositive infants were at a higher risk of acquiring CMV infection than seronegative ones. CMV infection did not give rise to specific immediate morbidity, and no deaths were attributed to CMV. The only source of nosocomial CMV infection was the transfused seropositive blood. Based on these findings, it was possible to formulate a CMV transfusion policy to premature infants in our region.

Cytomegalovirus Studies on Blood Donors in North‐East Scotland and a Review of UK Data

“…No correlation was found between CMV-specific IgM antibody and total CMV antibody or between CMV-specific IgM antibody and the donation's infectivity [36].…”

Transfusion-related Cytomegalovirus Infection Among Very Low Birth Weight Infants in an Endemic Area

“…Prior to the era of leukoreduction and irradiation, the rate of CMV acquisition among seropositive VLBWI receiving transfusions of fresh, CMV unscreened, nonirradiated, nonfiltered blood from a donor population in which seropositivity varied from 34-45.3% was 0-9% (1, 4, 5) compared with 0-0.8% after transfusion of CMV seronegative blood to CMV seronegative recipients (6, 7). The removal of the vast majority of WBCs from RBCs collected from seropositive donors decreases the transmission of CMV among seronegative recipients (8, 9); it has been reported that approximately 5-10% of original WBCs remained in the RBC components filtered with first-generation filters and this number of WBCs may be sufficient to transmit CMV to the recipients via lymphocyte activation.…”

“…However, this protective mechanism may not last long, as passively transferred CMV IgG eventually decreases. Galea et al reported that 36 of 38 VLBWI lost their passive CMV antibodies within 10 months (6). Similarly, we found that 97.5% of our VLBWI seroconverted within 9-10 months (mean: 5.5 months, range: 36-387 days), and the rate of CMV antibody loss was not affected by transfusions including FFP ( p =0.058).…”

Infectious complications in neonatal transfusion: Narrative review and personal contribution

“…In all CMV-TTI, the diagnosis was made through the DNA virus detection in pharyngeal swabs and urine (10 patients), and bloodstream (5 patients). Each patient received a median number of 5.5 RBC units (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Four patients were also given PLT (2 patients) or plasma (2 patients) transfusions.…”