ANZSBT releases position statement on prevention of TT-CMV 

The Australian and New Zealand Society of Blood Transfusion (ANZSBT) recently released a Position statement on prevention of transfusion-transmitted cytomegalovirus (TT-CMV).  

The statement reflects the ANZSBT consensus informed by a systematic review, haemovigilance data, pre-clinical evidence, and review of international guidance and concludes that:  

The collective evidence supports the use of pre-storage leucodepleted blood components as “CMV-safe” for immunosuppressed patients.   

CMV-seronegative cellular blood components do not offer additional benefit over leucodepletion in any population including immunosuppressed patients.   

Universal pre-storage leucodepletion of cellular blood components (red cells and platelets) was introduced by Lifeblood in 2008.  

The systematic review and meta-analysis underpinning the position statement was undertaken by ANZSBT’s Clinical Transfusion Practice Committee. It aimed to determine whether transfused patients receiving blood from donors with CMV-negative serology reduce the rate of CMV infection compared with unselected donors when all transfusions undergo pre-storage leucodepletion.    

The review found no cases of confirmed CMV transmission from leucodepleted blood products, and no difference in CMV infection rates in recipients of CMV-unscreened or serologically negative leucodepleted blood products.  

The ANZSBT position statement notes that:  

Granulocyte transfusions, or any other cellular blood component not able to be leucodepleted, should preferably be from CMV seronegative donors when the recipient is CMV seronegative. Clinical consideration of monitoring and pre-emptive therapy is likely to be required in most CMV seronegative recipients if CMV negative granulocytes cannot not be sourced.  

The ANZSBT position statement recommends:  

Suspected cases of TT-CMV in immunocompromised, neonatal or intrauterine patients, and CMV-seronegative transplant recipients should be investigated using a standardised pathway. This should include assessment of reactivation, other common sources including maternal CMV serostatus and breast-milk exposure prior to donor and component tracing and residual component testing where available.  

 Read the full position statement here and access the systematic review.