CMV seronegative products now available for intrauterine transfusion only

As communicated in customer letters 2017-22 and 2017-36, effective 2017-10-23, Canadian Blood Services will stop testing donor blood for anti-CMV antibodies except for a small inventory of blood components tested for the sole purpose of intrauterine transfusion. 

As the number of units tested will be very small, there is no opportunity to fill orders for CMV seronegative products outside of the single approved indication. All orders for CMV seronegative components for stock inventory and/or for patients with indications other than intrauterine transfusion will be filled with CMV-safe (pre-storage leukoreduced) components. 

If you work at one of the seven hospitals that currently performs intrauterine transfusions, and are served by Canadian Blood Services, we will maintain an inventory of two units of group O Rh negative CMV seronegative red blood cell (RBC) units that will also be C, E, and K antigen negative, and less than five days of age. A review of published literature, as well as a survey of hospitals serviced by Canadian Blood Services that perform intrauterine transfusions, indicates that this antigen mix will meet the majority of intrauterine transfusion patient needs.

We will also offer on-demand testing for RBC units negative for other RBC antigens for intrauterine transfusions only. The turnaround time for on-demand testing of RBC units negative for other RBC antigens will be 24 hours from the time the request is received at Canadian Blood Services.  

If a CMV seronegative platelet component is required for intrauterine transfusion (apheresis selected or unselected), suitable donors will be tested on demand. The turnaround time for on-demand testing of platelets will be 24 hours from the time the request is received at Canadian Blood Services.  

Intrauterine transfusions are scheduled procedures, and our survey results indicated that this turnaround time will meet the majority of intrauterine transfusion patient needs. In urgent situations, hospitals may wish to discuss options with their local Canadian Blood Services site.  

“When time is of the essence and a risk vs. benefit assessment favours urgent transfusion, I would be comfortable recommending the transfusion of pre-storage leukodepleted components for patients requiring an intrauterine transfusion”, says Dr. Gwen Clarke, Canadian Blood Services. 

Canadian Blood Services will rotate the inventory of CMV seronegative red blood cells to ensure units less than five days of age are available for intrauterine transfusion, so any hospital may receive an occasional CMV seronegative unit as part of their routine blood order. These units can be used interchangeably with regular (non-CMV tested) inventory. 

Educational and reference materials
There are several sources of reference information regarding this change in testing strategy that our hospital colleagues may find useful. You may use the video or either slide deck (with or without audio) for in house hospital information purposes.

1.  A video (11:04 min) recorded by Dr. Jeannie Callum, BA, MD, FRCPC, University of Toronto
2.  An extended version slide deck with audio (25:06 min)
3.   An extended version slide deck without audio
4.   The NAC website includes a list of  published references

Links to the video and slide decks can also be found on Canadian Blood Services’ Professional Education website.