Blood donor selection can prevent cytomegalovirus infection after open heart surgery

Thirty-four patients without IgG antibodies against cytomegalovirus (CMV) prior to open heart surgery were studied. The patients were randomized to receive blood either from unselected donors, or from donors without detectable CMV antibodies. Fresh whole blood was mainly used. Eleven patients received CMV seronegative blood only. All had an uneventful convalescence period and remained seronegative. Ten of the 23 patients who received blood from unselected donors had typical CMV disease with the onset of symptoms in the third or fourth postoperative week, and fever lasting for two to three weeks. They all had liver enzyme release and later seroconversion against CMV. Four patients were hospitalized during this period. The incidence of symptomatic CMV infection after open heart surgery was higher than usually reported among the CMV seronegative patients. Selection of blood donors who lack antibodies against CMV may be an adequate protective measure. Avoidance of fresh blood and reduced use of blood products are presumably also of importance.