Survey of Institutional Policies for Provision of "CMV-Safe" Blood in Ontario

Abstract

Objectives: Debate continues on whether leukoreduction alone (LR) is sufficiently similar to leukoreduced cellular products drawn from cytomegalovirus (CMV)-seronegative (SN) donors to minimize the risk of transfusion-transmitted CMV (TT-CMV). We sought to determine the policy, inventory, and practice landscape of the province for TT-CMV mitigation.

Methods: A web-based survey was distributed to hospitals in Ontario by Canadian Blood Services to collect data on their policies with respect to TT-CMV prevention.

Results: TT-CMV mitigation practices varied by patient population, hospital size, and region. Smaller institutions remain committed to dual prevention, whereas academic hospitals favor a single-measure approach. Although smaller institutions attempt to align their policies with leadership sites, emulation is often inaccurate. The demands for SN products also appear to be significantly lower than the current screening practices of Canadian Blood Services.

Conclusions: Standardization is lacking on practices to prevent TT-CMV. Although there are barriers to harmonizing practices, the apparent shift to policies acknowledging LR as a sufficient protection is likely to continue.

Keywords: Blood safety; Cytomegalovirus; Leukodepletion; Leukoreduction; Transfusion strategy; Transfusion-transmissible infections.