Transfus Med. 2025 Sep 17. doi: 10.1111/tme.70014. Online ahead of print.
ABSTRACT
BACKGROUND: Cytomegalovirus (CMV) infection remains a major cause of morbidity and mortality after allogeneic stem cell transplantation (aSCT). In 2012, the UK Advisory Committee for the Safety of Tissues and Organs (SaBTO) recommended that CMV-unselected (CMV-U) blood components could be safely transfused to this population without increasing the risk of transfusion-transmitted CMV (TTI-CMV). A 2015 survey of UK transplant centres found that 22.7% of aSCT centres did not follow this recommendation. In response, a subsequent good practice paper addressed concerns regarding the determination of pre-transplant CMV serostatus. Annual Serious Hazards of Transfusion (SHOT) reports continue to reassure, with no emerging safety concerns linked to the increased use of CMV-U blood components in this setting.
OBJECTIVES: To clarify changes in English practice regarding the provision of CMV-U blood components for potential allogeneic stem cell recipients and to identify factors contributing to the continued use of CMV-seronegative (CMV-N) blood components outside SaBTO recommendations.
METHODS: We surveyed English aSCT centres to establish current practices and perceptions.
RESULTS: Of the 32 English transplant centres, 28 responded (88%), 19 adult and nine paediatric centres; 10.7% continue to provide CMV-N components to all CMV-N potential aSCT recipients. Cited reasons include concerns for patients with primary immunodeficiency syndromes and a misperception that TTI-CMV is a ‘never event’. Furthermore, 17.9% of centres continue to provide CMV-N components contrary to SaBTO recommendations, citing risks of CMV disease in primary immunodeficiency syndromes, resolution of ambiguous CMV serostatus, and HIV infection.
CONCLUSION: Adherence to SaBTO guidance on transfusion of CMV-U blood components to aSCT recipients continues to improve, but further changes are likely to be challenging, based on the survey responses received and may require international collaboration.
PMID:40963142 | DOI:10.1111/tme.70014
