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Direct assessment of cytomegalovirus transfusion-transmitted risks after universal leukoreduction.
Transfusion. 2010 Apr; 50(4):776-86.T

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.

Authors+Show Affiliations

Department of Laboratory Medicine, Yale University School of Medicine, 20 York Street, CB 459, New Haven, CT 06510-3202, USA. yan.wu@yale.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19912585

Citation

Wu, Yanyun, et al. "Direct Assessment of Cytomegalovirus Transfusion-transmitted Risks After Universal Leukoreduction." Transfusion, vol. 50, no. 4, 2010, pp. 776-86.
Wu Y, Zou S, Cable R, et al. Direct assessment of cytomegalovirus transfusion-transmitted risks after universal leukoreduction. Transfusion. 2010;50(4):776-86.
Wu, Y., Zou, S., Cable, R., Dorsey, K., Tang, Y., Hapip, C. A., Melmed, R., Trouern-Trend, J., Wang, J. H., Champion, M., Fang, C., & Dodd, R. (2010). Direct assessment of cytomegalovirus transfusion-transmitted risks after universal leukoreduction. Transfusion, 50(4), 776-86. https://doi.org/10.1111/j.1537-2995.2009.02486.x
Wu Y, et al. Direct Assessment of Cytomegalovirus Transfusion-transmitted Risks After Universal Leukoreduction. Transfusion. 2010;50(4):776-86. PubMed PMID: 19912585.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Direct assessment of cytomegalovirus transfusion-transmitted risks after universal leukoreduction. AU - Wu,Yanyun, AU - Zou,Shimian, AU - Cable,Ritchard, AU - Dorsey,Kerri, AU - Tang,Yanlin, AU - Hapip,Cheryl Anne, AU - Melmed,Russell, AU - Trouern-Trend,Jonathan, AU - Wang,Jian-Hui, AU - Champion,Melanie, AU - Fang,Chyang, AU - Dodd,Roger, Y1 - 2009/11/13/ PY - 2009/11/17/entrez PY - 2009/11/17/pubmed PY - 2010/5/6/medline SP - 776 EP - 86 JF - Transfusion JO - Transfusion VL - 50 IS - 4 N2 - 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. SN - 1537-2995 UR - https://www.unboundmedicine.com/medline/citation/19912585/Direct_assessment_of_cytomegalovirus_transfusion_transmitted_risks_after_universal_leukoreduction_ L2 - https://doi.org/10.1111/j.1537-2995.2009.02486.x DB - PRIME DP - Unbound Medicine ER -