Use of CMV serologically tested CMV negative FFP

A colleague who works in the Heartland of America reports that her hospital historically has stocked serologically tested CMV negative group AB FFP either as full units or as 'split quad pack' aliquots for NICU patients and for neonatal 'cardiac patients'. In her many years of blood banking she has worked at other facilities with NICU services and with transplant programs, and the use of serologically tested CMV negative FFP was never a concern. She wonders if others would comment on their current utilization of serologically tested CMV negative FFP (as well as related products, such as Plasma that has been frozen within 24 hours of collection and/or Thawed Plasma) and the reasoning behind the approach.

The following comments have been received.

ADDENDA Oct. 19, 2005

1. Maurene K. Viele, MD at the Transfusion Service, Stanford University Medical Center (attribution used with permission) reports that their transfusion service supports very active transplant services (both pediatric and adult) as well as a large neonatal ICU and a very active pediatric heart surgery program (center of excellence for pediatric transplant, pediatric heart surgery, pediatric cancers). She reports that they do not stock serologically tested CMV-antibody negative FFP of any ABO type.

ADDENDA Oct. 21, 2005

2. Neil Blumberg MD, Director, Clinical Laboratories, Strong Memorial Hospital and Director, Transfusion Medicine/Blood Bank University of Rochester Medical Center (attribution used with permission) reports that his hospital transfusion service does not stock CMV seronegative FFP as he does not believe that FFP transmits CMV, nor any other frozen product, as far as he knows. However, he acknowledges that FFP which has been collected from a CMV antibody positive donor can transfer anti-CMV antibodies to the recipient which might interfere with CMV diagnosis, should antibody detection methods be used for that purpose. However, at his hospital the diagnosis of newly acquired CMV in high risk patients usually involves CMV culture rather than serology, and they find surveillance culturing much more useful, as culture positivity occurs before any serologic response, particularly in immunologically immature or compromised patients.
   
   So he asks the question, why are they giving CMV seronegative FFP in the first place? He also believes that newborn intensive care patients and cardiac surgery patients should be receiving leukoreduced red cells and platelets, so that CMV infection in those populations should be nil from transfusion. This leaves only maternal or nosocomial infections with CMV, which are only an issue for newborns or the immunocompromised in most cases. In summary, his hospital does not transfuse CMV serotested components of any sort, at any time, with the exception of the rare granulocyte concentrate. They employ leukoreduction of all cellular components to provide CMV risk reduction for all patients with this one exception.

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