Transfusion-acquired cytomegalovirus infection in cardiac surgery patients

The incidence of transfusion-acquired primary cytomegalovirus (CMV) infection was studied in 483 cardiac surgery patients. Ninety-six patients (20%) were found to lack antibody to CMV [CMV Ab(−)] as measured by radioimmunoassay. Sixty-eight CMV Ab(−) were followed by viral culture and/or serology from eight weeks to one year after transfusion. Transfusion requirements in CMV Ab(−) patients were as follows: whole blood/packed red blood cells, mean 4.7 ± 2.6 units; platelets (20 patients), 6.9 ± 3.8 units; fresh frozen plasma (25 patients), mean 3.3 ± 1.6 units. Forty-nine percent of 235 donor units tested had antibody to CMV. One donor unit (0.4%) had CMV-specific IgM. This was not associated with CMV infection in the recipient. One patient (1.5%) demonstrated evidence of seroconversion to CMV during the follow-up period. This is significantly less than reported in previously published studies (P <.01). Serological methods used, the age of the transfused blood, the immune status of the transfusion recipient, and the administration of passive antibody in fresh frozen plasma are factors that may be responsible for the low incidence observed.