I developed this policy for HMC Doha where most of the local population are CMV-seropositive. Note that I used the CE definition of <1E6 instead of the American <5E6.
Since most of the local population (>90%) are CMV-seropositive, it is impractical to rely on CMV-negative donors as our basis for CMV prophylaxis. Instead, we perform universal leukodepletion and pathogen-inactivation to greatly reduce this risk:
- CMV transmission risk can be lowered to a level comparable to using CMV-seronegative components by universal leukodepletion to levels <1E6.
- Pathogen inactivation greatly reduces (at least 2 log10) the number of organisms with nucleic acid (DNA or RNA) and is used for all platelet (pools and apheresis) and plasma components.
- Platelet additive solution reduces the amount of original plasma to about 35 ml and further reduces donor exposure to foreign material.
- All blood components (platelets, plasma, RBCs) are universally leukodepleted to residual levels below 1E6.
- All platelet and plasma components are pathogen-inactivated using the Mirasol system (riboflavin added and then exposed to ultraviolet light).
- All platelet components (pooled buffy coat and apheresis) are prepared in platelet additive solution PAS.
- Technical Manual, AABB, Current Edition, Bethesda, Maryland, USA
- Standards for Blood Banks and Transfusion Services, Current Edition, AABB, Bethesda, Maryland, USA
- Guidelines to the Preparation, Use, and Quality Assurance of Blood Components, European Committee (Partial Agreement) on Blood Transfusion (CD-P-TS), Current Edition