Some red cell and platelet donations (from donors previously testing Cytomegalovirus (CMV) negative and new donors) are screened by the Blood Service for the presence of CMV antibodies to provide a CMV seronegative inventory of cellular components.
As transmission of CMV disease is associated with cellular components, donations manufactured into 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 seronegativity for CMV completely eliminates risk of CMV transmission. Some data suggest CMV seronegative components and leucodepleted components have equivalent risk of CMV transmission.
When should I use this modification?
CMV seronegative components are provided to hospitals on request for specific CMV seronegative patients who are at risk for severe CMV disease including:
Recipients of allogeneic or autologous stem cell, bone marrow or solid organ transplants
Recipients of highly immunosuppressive chemotherapy (eg, leukaemia or lymphoma)
Recipients of intrauterine red cell transfusions
Premature (<1500 g) or immunocompromised neonates
- Pregnant women who require transfusion regardless of CMV status
When CMV seronegative blood components are required, the following recommendations should be followed:
Select CMV seronegative components whenever possible
If not available, leucocyte depleted components are considered to offer a high level of safety in preventing CMV transmission
- Carefully monitor for CMV infection and disease in high risk patients.
For further details, consult the ANZSBT Guidelines for Transfusion and Immunohaematology and Laboratory Practice (2016).
Guidance on the use of CMV seronegative components and in particular clinical indications for prioritising CMV seronegative blood components in times of supply shortage can be found in the platelet annex of the National Blood Supply Contingency Plan.