CMV-Safe Blood Products

Description

Although typically of little consequence in immunocompetent individuals, primary cytomegalovirus (CMV) infection is associated with considerable morbidity and mortality in at-risk populations. TT-CMV is a serious complication of cellular blood product transfusion.

Indications

Studies suggest that 13%–37% of immunocompromised patients will contract TT-CMV from transfusion of unfiltered cellular blood components that are not mitigated for CMV. Populations at greatest risk for TT-CMV include fetuses (intrauterine transfusion), premature low-birth-weight infants (<1250–1500 g) born to seronegative mothers, seronegative recipients of seronegative allogeneic or autologous hematopoietic stem cell (HSC) transplants, seronegative recipients of seronegative solid organ transplants, and seronegative patients with HIV infection ( Table 44.1 ). Primary infection in these patients can lead to serious end organ damage or failure, including CMV hepatitis, retinitis, colitis, interstitial pneumonitis, esophagitis, polyradiculopathy, transverse myelitis, and subacute encephalitis.

Additional groups that may benefit from CMV-safe transfusion products include pregnant women who are seronegative, to prevent primary infection to the fetus, and seronegative patients who are candidates for HSC transplantation.

Processing and Storage