transfusion

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a consultant in cardiac surgery at Bristol Royal Infirmary and a senior lecturer at the University of Bristol who studies the impact of blood transfusions on patients,

Two important potential sources of CMV infection in premature infants are blood transfusions and breast milk.

and leukoreduced (blood products with white blood cells removed) effectively prevents transmission of CMV from blood transfusion.

Using this transfusion approach maternal breast milk becomes the primary source of postnatal CMV infection among VLBW infants.

and at the time of enrollment they had received not a blood transfusion. The infants were tested at birth to evaluate for congenital infection and again at five additional intervals between birth and 90 days discharge or death.

Although 2061 transfusions were administered to 310 of the infants (57.5 percent) the blood products were CMV-seronegative

and leukoreduced and none of the CMV infections was linked to transfusion. Twenty-seven of 28 infections acquired after birth occurred among infants fed CMV-positive breast milk.

We believe our study is the largest evaluation of both blood transfusion and breast-milk sources of postnatal CMV infection in VLBW infants says first author Cassandra Josephson MD from the Center for Transfusion and Cellular Therapies Department of Pathology and Laboratory

Medicine Emory University School of medicine and Children's Healthcare of Atlanta. Previously the risk of CMV infection from blood transfusion of seronegative or leukoreduced transfusions was estimated to be 1 to 3 percent.

We showed that using blood components that are both CMV-seronegative and leukoreduced we can effectively prevent the transfusion-transmission of CMV.

Therefore we believe that this is the safest approach to reduce the risk of CMV infection when giving transfusions to VLBW infants.

The American Academy of Pediatrics currently states that the value of routinely feeding breast milk from CMV seropositive mothers to preterm infants outweighs the risks of clinical disease from CMV.