Cytomegalovirus Infectivity in Whole Blood
Cytomegalovirus Infectivity in Whole Blood
Cytomegalovirus (CMV) may be transmitted by transfusion of whole blood and cellular components processed according to standard processing procedures. A need exists to develop new procedures to remove CMV and other leukocyte-borne viruses from donor blood. Ten patients (AIDS/bone marrow transplants) who were CMV antigenemic (virus subsequently confirmed by isolation), donated 50 mL of venous blood within 24 to 72 hours of the initial antigen detection. Twenty-five-milliliter aliquots of each specimen were passed through Purecell Neo Neonatal Leukocyte Reduction Filters (Pall, East Hills, NY). The remaining 25-mL nonfiltered aliquots, as well as the blood filtrates, were subjected to infectivity endpoint determinations. The Purecell Neo filter effected a 3 to 4 log10 leukocyte reduction. CMV input titers ranged from less than 10 to 7.3
10 median tissue culture infectious dose (TCID 50) per milliliter. CMV was not isolated from any postfiltration effluent (ie, leukocytes, erythrocytes, or plasma). CMV DNA was not detected by nested polymerase chain reaction in 8 of 10 postfiltrate blood specimens. The Purecell Neo filter was efficacious in eliminating or significantly reducing viral (CMV) load in venous blood.
Leukocyte reduction is relevant to current hemotherapy in patients susceptible to leukocyte-derived complications such as febrile nonhemolytic transfusion reactions, HLA platelet alloimmunization, inflammatory reaction to extracorporeal circulation, or leukocyte-borne viral (eg, cytomegalovirus [CMV]) infections.Among immunosuppressed patients, the transmission of leukocyte-borne viruses during blood transfusions may cause serious morbidity and mortality.
Although screening of blood donors is performed to identify blood with a negative serologic result for CMV, false-negative serologic results have been reported. Furthermore, other potential leukocyte-borne infectious contaminants (eg, Epstein-Barr virus; human herpes virus types 6, 7, and 8; human foamy viruses [Spumavirus]; prions), are not subjected to routine pretransfusion screening.Accordingly, leukocyte reduction by filtration is performed or is being implemented on donated blood in several countries (eg, France, Ireland, Norway, Portugal, the United Kingdom, Australia, Canada, and the United States).
The purpose of the present study was to evaluate the efficacy of leukocyte filtration, using the Purecell Neo Neonatal Leukocyte Reduction Filter (Pall, East Hills, NY) as a technology to remove leukocyte-borne CMV from venous blood. This leukocyte-reduction technology was studied using both conventional cell culture and polymerase chain reaction (PCR) technologies.
Cytomegalovirus (CMV) may be transmitted by transfusion of whole blood and cellular components processed according to standard processing procedures. A need exists to develop new procedures to remove CMV and other leukocyte-borne viruses from donor blood. Ten patients (AIDS/bone marrow transplants) who were CMV antigenemic (virus subsequently confirmed by isolation), donated 50 mL of venous blood within 24 to 72 hours of the initial antigen detection. Twenty-five-milliliter aliquots of each specimen were passed through Purecell Neo Neonatal Leukocyte Reduction Filters (Pall, East Hills, NY). The remaining 25-mL nonfiltered aliquots, as well as the blood filtrates, were subjected to infectivity endpoint determinations. The Purecell Neo filter effected a 3 to 4 log10 leukocyte reduction. CMV input titers ranged from less than 10 to 7.3
10 median tissue culture infectious dose (TCID 50) per milliliter. CMV was not isolated from any postfiltration effluent (ie, leukocytes, erythrocytes, or plasma). CMV DNA was not detected by nested polymerase chain reaction in 8 of 10 postfiltrate blood specimens. The Purecell Neo filter was efficacious in eliminating or significantly reducing viral (CMV) load in venous blood.
Leukocyte reduction is relevant to current hemotherapy in patients susceptible to leukocyte-derived complications such as febrile nonhemolytic transfusion reactions, HLA platelet alloimmunization, inflammatory reaction to extracorporeal circulation, or leukocyte-borne viral (eg, cytomegalovirus [CMV]) infections.Among immunosuppressed patients, the transmission of leukocyte-borne viruses during blood transfusions may cause serious morbidity and mortality.
Although screening of blood donors is performed to identify blood with a negative serologic result for CMV, false-negative serologic results have been reported. Furthermore, other potential leukocyte-borne infectious contaminants (eg, Epstein-Barr virus; human herpes virus types 6, 7, and 8; human foamy viruses [Spumavirus]; prions), are not subjected to routine pretransfusion screening.Accordingly, leukocyte reduction by filtration is performed or is being implemented on donated blood in several countries (eg, France, Ireland, Norway, Portugal, the United Kingdom, Australia, Canada, and the United States).
The purpose of the present study was to evaluate the efficacy of leukocyte filtration, using the Purecell Neo Neonatal Leukocyte Reduction Filter (Pall, East Hills, NY) as a technology to remove leukocyte-borne CMV from venous blood. This leukocyte-reduction technology was studied using both conventional cell culture and polymerase chain reaction (PCR) technologies.