The Risk of Cytomegalovirus Infection in Seronegative Transfusion Recipients Not Receiving Exogenous Immunosuppression

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Abstract
We studied 637 transfusion recipients seronegative for cytomegalovirus (CMV) in the following categories: neonates; pregnant women; and patients experiencing trauma, burns, cardiovascular surgery (adult or pediatric), major surgery, or gastrointestinal hemorrhages. Cultures and serological tests were used to follow up subjects for evidence of CMV infection for a period of three months after their last transfusion. Six (0.9%) developed CMV infection. No significant differences in risk among patient categories were observed. Infected patients received a significantly larger mean number of units of cellular blood products (CBP; 50.0 ± 38.9 vs. 6.2 ± 8.5; P < .001) and plasma (23.7 ± 15.3 vs. 2.6 ± 4.6, P < .001) than did uninfected patients. This result represents a risk per unit of CBP transfused of 0.14%, or ∼0.38% per unit of seropositive CBP transfused. We observed, however, that patients exposed to CBP from > 30 donors had a higher risk of acquiring CMV infection than would be predicted if infectious units were randomly distributed among all donors (P < .01).