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Herpesvirus causing self-limiting infection in immunocompetent individua= ls, but with potentially severe consequences in immuno-suppressed transplan= t patients.
Recipient
ACCEPTABLE
ACCEPTABLE
CMV IgG should be performed at CT to ascertain donor CMV serostatus.
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.
Testing outcomes and guidance
1)
CMV-IgM =3D negative, CMV-IgG =3D positive or negative
CMV-IgM =3D positive, CMV-IgG =3D positive, CMV-PCR negative
Status information should be reported to the transplant centre=
em>
With these combinations of serology and PCR, the donor can be cleare= d at workup. If there is a change of CMV status from CT to work-up stage, t= he transplant centre should be informed immediately.
CMV-IgG weak positive results should be validated with reference sta= ndard serology (e.g. immunoblot)
2)
CMV-IgM =3D positive and CMV-IgG =3D negative and CMV-PCR=3Dnegative
Immunoblots should be performed to validate the serology results. Re= sults should be communicated with TC.
3) CMV-PCR =3D positive
Donor cannot be cleared. Inform transplant centre and discuss donor = deferral
CMV can cause devastating complications in post-transplant recipients. A= ccurate donor CMV serostatus plays an important role in donor selection.
Pergam SA, Xie H, Sandhu R, et al. Efficiency and Risk Factors for CMV T= ransmission in Seronegative Hematopoietic Stem Cell Recipients. Biology of = blood and marrow transplantation=E2=80=AF: journal of the American Society = for Blood and Marrow Transplantation. 2012;18(9):1391-1400. doi:10.1016/j.b= bmt.2012.02.008. [1]
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