Difference between revisions of "Cytomegalovirus"
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− | == | + | ==Condition== |
− | |||
− | + | Herpesvirus causing self-limiting infection in immunocompetent individuals, but with potentially severe consequences in immuno-suppressed transplant patients. | |
− | |||
− | ==Individual at | + | ==Individual at risk== |
− | |||
− | + | Recipient | |
− | |||
− | ==Guidance== | + | ==Guidance at RECRUITMENT== |
− | + | ||
+ | ACCEPTABLE | ||
+ | |||
+ | ==Guidance at CT== | ||
+ | |||
+ | ACCEPTABLE | ||
+ | |||
+ | CMV IgG should be performed at CT to ascertain donor CMV serostatus. | ||
+ | |||
+ | |||
+ | ==Guidance 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 = negative, CMV-IgG = positive or negative | ||
+ | |||
+ | CMV-IgM = positive, CMV-IgG = positive, CMV-PCR negative | ||
+ | |||
+ | |||
+ | Status information should be reported to the transplant centre | ||
+ | |||
+ | 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 referred to reference lab for confirmation | ||
+ | |||
+ | |||
+ | |||
+ | 2 | ||
+ | |||
+ | CMV-IgM = positive and CMV-IgG = negative and CMV-PCR=negative | ||
+ | |||
+ | Donor can be cleared. Inform TC. | ||
+ | |||
+ | |||
+ | |||
+ | |||
+ | 3 | ||
+ | |||
+ | CMV-PCR = positive | ||
+ | |||
+ | Donor cannot be cleared. Deferred for 4-6 weeks and repeat CMV PCR then. | ||
+ | |||
+ | Inform transplant centre | ||
+ | |||
+ | ==Justification for guidance== | ||
+ | |||
+ | CMV can cause devastating complications in post-transplant recipients. Accurate donor CMV serostatus plays an important role in donor selection. | ||
+ | |||
+ | |||
+ | |||
+ | |||
+ | ==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 transplantation : journal of the American Society for Blood and Marrow Transplantation. 2012;18(9):1391-1400. doi:10.1016/j.bbmt.2012.02.008. [1] | ||
− | |||
− | |||
==Pseudonyms or Related Conditions== | ==Pseudonyms or Related Conditions== | ||
Line 22: | Line 76: | ||
==Version== | ==Version== | ||
− | Version | + | Version 2, Edition 1 |
====Date of Last Update==== | ====Date of Last Update==== | ||
− | + | 9 June 2016 |
Latest revision as of 08:46, 16 April 2018
Contents
Condition
Herpesvirus causing self-limiting infection in immunocompetent individuals, but with potentially severe consequences in immuno-suppressed transplant patients.
Individual at risk
Recipient
Guidance at RECRUITMENT
ACCEPTABLE
Guidance at CT
ACCEPTABLE
CMV IgG should be performed at CT to ascertain donor CMV serostatus.
Guidance 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 = negative, CMV-IgG = positive or negative
CMV-IgM = positive, CMV-IgG = positive, CMV-PCR negative
Status information should be reported to the transplant centre
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 referred to reference lab for confirmation
2
CMV-IgM = positive and CMV-IgG = negative and CMV-PCR=negative
Donor can be cleared. Inform TC.
3
CMV-PCR = positive
Donor cannot be cleared. Deferred for 4-6 weeks and repeat CMV PCR then.
Inform transplant centre
Justification for guidance
CMV can cause devastating complications in post-transplant recipients. Accurate donor CMV serostatus plays an important role in donor selection.
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 transplantation : journal of the American Society for Blood and Marrow Transplantation. 2012;18(9):1391-1400. doi:10.1016/j.bbmt.2012.02.008. [1]
Pseudonyms or Related Conditions
CMV
Version
Version 2, Edition 1
Date of Last Update
9 June 2016