Postnatal cytomegalovirus infection: a pilot comparative effectiveness study of transfusion safety using leukoreduced-only transfusion strategy

Transfusion. 2016 Aug;56(8):1945-50. doi: 10.1111/trf.13605. Epub 2016 Apr 15.


Background: The optimal mitigation strategy to prevent transfusion transmission of cytomegalovirus (TT-CMV) in preterm very low birthweight infants remains debated. Hospitals caring for this patient population have varied practices.

Study design and methods: A prospective observational comparative effectiveness pilot study was conducted to determine the feasibility for a larger study. The pilot was carried out at hospitals using a leukoreduction (LR)-only transfusion strategy. Specimen and data collection for this study was performed in a similar approach to a study completed at Emory University that employed the CMV-seronegative plus LR approach. All testing was performed at one laboratory. The rates of TT-CMV using the two transfusion strategies were compared.

Results: Zero incidence of TT-CMV was detected in infants (n = 20) transfused with LR-only blood (0/8; 95% confidence interval [CI], 0-25.3%) and is consistent with the previously reported zero incidence of TT-CMV finding in a cohort of infants transfused with CMV-negative plus LR blood (0/310; 95% CI, 0%-0.9%). The seroprevalence rate among enrolled mothers (n = 17) was 60%. Forty percent of those infants (8/20) received 43 transfusions; five were transfused with one or more CMV-seropositive blood components. One infant had tested positive for CMV before receiving blood transfusions; the infant's mother was CMV immunoglobulin (Ig)G positive and IgM negative.

Conclusions: Using the LR-only transfusion approach, zero cases of TT-CMV were detected in this pilot study. A larger study is needed to reliably determine the most effective strategy for prevention of TT-CMV in this population.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cytomegalovirus / pathogenicity
  • Cytomegalovirus Infections / etiology*
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Very Low Birth Weight
  • Leukocyte Reduction Procedures / methods*
  • Male
  • Prospective Studies
  • Transfusion Reaction*