Posttransfusion cytomegalovirus infections

Prospective studies of transfused immunocompetent patients in the 1960s and early 1970s showed high rates of cytomegalovirus (CMV) infection, ranging from 16% to 67%. Similar studies conducted in the 1980s have reported rates of infection of 1% in seronegative patients. Little morbidity or mortality has been associated with these CMV infections. In contrast, transfusion-transmitted CMV infections in seronegative immunocompromised premature infants and bone marrow transplant recipients have resulted in significant morbidity and mortality. Blood transfusion is a less important risk factor in recipients of solid organ transplants. The risk of infection, however, can be reduced by providing blood from CMV-seronegative donors or frozen deglycerolized red blood cells. Leukocyte removal by filtration or centrifugation is also likely to reduce the risk. Prophylaxis with CMV immune globulin can ameliorate the severity of posttransfusion-posttransplant CMV infections.