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This page was last modified on 7 March 2015, at 23:43.

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Condition

Herpesvirus causing self-limiting infection in immunocompetent individuals, but with potentially severe consequences in immuno-suppressed transplant patients.

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Individual at risk

Recipient

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Guidance at RECRUITMENT

ACCEPTABLE

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Guidance at CT

ACCEPTABLE

CMV IgG should be performed at CT to ascertain donor CMV serostatus.

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Guidance at WORK-UP

Recommended testing at work-up:

CMV-IgG and IgM should be performed at work-up. If CMV IgM is postitive, CMV-PCR should be undertaken.

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Testing outcomes and guidance


1)

CMV-IgM = negative, CMV-IgG = positive or negative

CMV-IgM = positive, CMV-IgG = positive, CMV-PCR negative


Status information should be reported to the transplant centre

With these combinations of serology and PCR, the donor can be cleared at workup. If there is a change of CMV status from CT to work-up stage, the transplant centre should be informed immediately.

CMV-IgG weak positive results should be validated with reference standard serology (e.g. immunoblot)

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2)

CMV-IgM = positive and CMV-IgG = negative and CMV-PCR=negative

Immunoblots should be performed to validate the serology results. Results should be communicated with TC.

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3) CMV-PCR = positive

Donor cannot be cleared. Inform transplant centre and discuss donor deferral

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Justification for guidance

CMV can cause devastating complications in post-transplant recipients. Accurate donor CMV serostatus plays an important role in donor selection.

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References

Pergam SA, Xie H, Sandhu R, et al. Efficiency and Risk Factors for CMV Transmission in Seronegative Hematopoietic Stem Cell Recipients. Biology of blood and marrow transplantationโ€ฏ: journal of the American Society for Blood and Marrow Transplantation. 2012;18(9):1391-1400. doi:10.1016/j.bbmt.2012.02.008.ย [1]

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Notes

Page created 7th March 2015

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