Should directed donations intended for neonates be screened for CMV antibody in addition to being leukoreduced?
A colleague in California reports that her hospital asks their regional supplier to provide CMV seronegative blood products for neonatal transfusion. She adds that it has been a struggle to fill these orders, even though their inventory plan is to maintain a stock of one group O Rh positive and one group O Rh negative, CPDA-1, CMV antibody-negative, leukoreduced, irradiated RBC for support of patients in the neonatal ICU. On the other hand, their hospital has not been testing directed donors (such as the parents of the ICU babies) for antibodies to CMV. The directed donations are merely irradiated and leukocyte reduced. Recently, their neonatal ICU has begun to request that the directed donations also be tested for antibodies to CMV. Since a significant percentage of their adult population is CMV seropositive she is concerned that they may need to exclude many RBC units that have been donated by family members. She laments, "What will we do when we can no longer obtain CMV seronegative directed donor units?"
Colleagues are encouraged to share their local strategies for managing this problem.
The following comments have been received.
ADDENDA Feb. 19, 2004
- Kathleen A. Houston, MT(ASCP)SBB, Technical Supervisor, Transfusion Medicine at the Children's Hospital Association in Denver, CO (attribution used with permission) states that for a number of years, since leukoreduction filters have been available, they have transfused leukoreduced products to all neonates without regard to CMV serostatus of blood products. This includes infants on ECMO, infants undergoing cardiac transplant and infants who had a history of intrauterine transfusions. The rare exception for CMV screening is in the case of granulocyte transfusion when it is, of course, necessary.
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