A limited number of donors, including new donors and donors previously identified as cytomegalovirus (CMV) negative are tested for the presence of CMV antibodies. This enables Lifeblood to maintain an inventory of CMV seronegative red cell and platelet donations which are available on request for specific clinical indications.
As transmission of CMV disease is associated with cellular components, fresh frozen plasma, cryoprecipitate and other plasma-derived blood components do not require CMV screening.
All cellular products in Australia are leucodepleted. Neither leucodepletion nor CMV seronegativity completely eliminates the risk of CMV transmission. Some data suggest CMV seronegative components and leucodepleted components have equivalent risk of CMV transmission. Whether using a combination of leucocyte depletion and CMV-seronegative components provides any additional safety benefits is unknown. For at-risk patients early detection of CMV infection by polymerase chain reaction (PCR) monitoring should be considered.
When should I use this modification?
CMV seronegative products should be used for the following clinical indications:
Pregnant women regardless of CMV status who require regular elective transfusions during pregnancy (but not during delivery);
Recipients of intrauterine transfusions IUT;
Neonates (up to 28 days post expected date of delivery) and
- Granulocyte transfusions for CMV negative patients.
For other groups, the use of CMV seronegative or leucodepleted blood products (i.e. CMV safe), will be dictated by local clinical policies:
Solid organ transplants;
Haemopoietic stem cell transplants (HSCT);
Haematology and oncology patients and
Immunodeficient patients, including those with HIV.
For further details, consult the ANZSBT Guidelines for Transfusion and Immunohaematology and Laboratory Practice.
Guidance on the use of CMV seronegative platelets during supply shortages can be found in the platelets response plan (annex C) of the National Blood Supply Contingency Plan.