title: Postnatal cytomegalovirus infection: a pilot comparative effectiveness study of transfusion safety using leukoreduced-only transfusion strategy.
abstract: The optimal mitigation strategy to prevent transfusion transmission of cytomegalovirus (TT-CMV) in preterm very low birthweight infants remains debated. Hospitals caring for this patient population have varied practices.
  
  
  
  A prospective observational comparative effectiveness pilot study was conducted to determine the feasibility for a larger study. The pilot was carried out at hospitals using a leukoreduction (LR)-only transfusion strategy. Specimen and data collection for this study was performed in a similar approach to a study completed at Emory University that employed the CMV-seronegative plus LR approach. All testing was performed at one laboratory. The rates of TT-CMV using the two transfusion strategies were compared.
  
  
  
  Zero incidence of TT-CMV was detected in infants (n = 20) transfused with LR-only blood (0/8; 95% confidence interval [CI], 0-25.3%) and is consistent with the previously reported zero incidence of TT-CMV finding in a cohort of infants transfused with CMV-negative plus LR blood (0/310; 95% CI, 0%-0.9%). The seroprevalence rate among enrolled mothers (n = 17) was 60%. Forty percent of those infants (8/20) received 43 transfusions; five were transfused with one or more CMV-seropositive blood components. One infant had tested positive for CMV before receiving blood transfusions; the infant's mother was CMV immunoglobulin (Ig)G positive and IgM negative.
  
  
  
  Using the LR-only transfusion approach, zero cases of TT-CMV were detected in this pilot study. A larger study is needed to reliably determine the most effective strategy for prevention of TT-CMV in this population.
authors.affiliation: University of Washington.|Bloodworks Northwest, Seattle, Washington.
authors.forename: Meghan
authors.initials: M
authors.lastname: Delaney
authors.affiliation: University of Washington.
authors.forename: Dennis
authors.initials: D
authors.lastname: Mayock
authors.affiliation: Emory University, Atlanta, Georgia.
authors.forename: Andrea
authors.initials: A
authors.lastname: Knezevic
authors.affiliation: University of Washington.
authors.forename: Colette
authors.initials: C
authors.lastname: Norby-Slycord
authors.affiliation: Seattle Children's Hospital, Seattle.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kleine
authors.affiliation: Emory University, Atlanta, Georgia.
authors.forename: Ravi
authors.identifier: 0000-0002-7444-5550
authors.initials: R
authors.lastname: Patel
authors.affiliation: Emory University, Atlanta, Georgia.
authors.forename: Kirk
authors.initials: K
authors.lastname: Easley
authors.affiliation: Emory University, Atlanta, Georgia.
authors.forename: Cassandra
authors.initials: C
authors.lastname: Josephson
mesh_terms: D003587:Cytomegalovirus / Q000472:pathogenicity; D003586:Cytomegalovirus Infections / Q000209:etiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D047589:Leukocyte Reduction Procedures / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D065227:Transfusion Reaction