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- Title
Direct assessment of cytomegalovirus transfusion-transmitted risks after universal leukoreduction.
- Authors
Yanyun Wu; Shimian Zou; Cable, Ritchard; Dorsey, Kerri; Yanlin Tang; Hapip, Cheryl Anne; Melmed, Russell; Trouern-Trend, Jonathan; Jian-Hui Wang; Champion, Melanie; Chyang Fang; Dodd, Roger
- Abstract
BACKGROUND: Cytomegalovirus (CMV) transfusion-transmitted disease (TTD) remains a clinical concern. Universal leukoreduction has become one of the main strategies for the prevention of CMV-TTD. Through prospective clinical follow-up and testing of transfusion recipients (TRs), the risk for CMV-TTD was studied. STUDY DESIGN AND METHODS: Transfused units were all leukoreduced and not prospectively screened for CMV. For TRs with negative baseline CMV testing results (CMV total antibody and DNA), all follow-up TR samples were tested for CMV total antibody and DNA, and retained linked donor serum samples were tested for CMV total antibody. In cases when CMV-TTD was suspected, donor sera were also tested for CMV DNA and selected TR samples were tested for CMV immunoglobulin M antibody. Evaluable transfusion was defined as a transfusion with TR sample(s) collected 14 to 180 days posttransfusion. RESULTS: Forty-six TRs were negative for CMV at baseline. There were 1316 evaluable cellular blood transfusions to these TRs. Of 1316 evaluable cellular products, 460 (35%) were positive for CMV total antibody tested using linked donor samples. Three cases of probable CMV-TTD were found; however, there was no definitive proof from donor follow-up that they were transfusion associated. CONCLUSION: Among all 46 baseline seronegative recipients and 1316 evaluable transfusions, the calculated overall CMV-TTD risk was up to 6.5% (95% confidence interval [CI], 1.0%-18.0%) in terms of TRs and up to 0.23% (95% CI, 0.06%-0.62%) in terms of non–CMV-screened leukoreduced cellular products. In summary, after universal leukoreduction, CMV-TTD, while uncommon, may still occur.
- Subjects
CYTOMEGALOVIRUSES; BLOOD transfusion; BLOOD donors; SERUM; IMMUNOGLOBULIN genes
- Publication
Transfusion, 2010, Vol 50, Issue 4, p776
- ISSN
0041-1132
- Publication type
Article
- DOI
10.1111/j.1537-2995.2009.02486.x