The strategies for reducing cytomegalovirus (CMV) infections include transfusion of CMV-seronegative or partially leukoreduced cellular components.

Héma-Québec performs leukoreduction on all units of red blood cells and platelets. As such, the risk of cytomegalovirus (CMV) transmission is greatly reduced and is considered equivalent to the risk of CMV transmission through blood products from CMV-seronegative donors.

Granulocytes intended for CMV-seronegative recipients should be collected from CMV-seronegative donors.

As for plasma, the transforming of whole blood and the freezing methods mean that it is considered CMV-free and with no apparent risk of CMV transmission, even without additional filtration.

Action

The purpose of transfusing CMV-seronegative or partially leukoreduced cellular components is to prevent, in immunocompromised people, the transmission of CMV, which can cause diseases like pneumonia, hepatitis or colitis; they can be very serious, even fatal.

Main indications

The Comité consultatif national de médecine transfusionnelle (CCNMT) recommends that:

1. The use of anti-CMV IgG/IgM seronegative cellular blood products be restricted to:
   • intrauterine transfusions; and
   • granulocyte transfusions in CMV-seronegative recipients or recipients with unknown CMV status.
2. If CMV-seronegative blood products are not available for an intrauterine transfusion, either in an emergency situation or due to the erythrocytic or platelet phenotype required, only leukoreduced units can be administered, based on the attending physician’s judgement. This option is not recommended for granulocyte units.
3. Leukoreduced products and products that are anti-CMV IgG/IgM seronegative are considered equivalent in terms of their effectiveness in preventing CMV transmission for all other uses.

Contraindications

None of the CMV-mitigation strategies that currently exist (i.e., serological screening of donors and leukoreduction) remove the DNA or virions of the CMV that can be found in the donor’s plasma, either during the period when the CMV serology is negative or during reactivation of the CMV.

Dosage and administration

Refer to the dosage and administration specific to each product.

Storage

Refer to the storage specific to each product.

In the event of a discrepancy between the information on this page and what is in the Circular of information, the latter will take precedence.