{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:18:57Z","timestamp":1788347937566,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,10,19]],"date-time":"2018-10-19T00:00:00Z","timestamp":1539907200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["17H04341"],"award-info":[{"award-number":["17H04341"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["16GK0110021S0101"],"award-info":[{"award-number":["16GK0110021S0101"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Cytomegalovirus (CMV) transmission to very\u2010low\u2010birth\u2010weight infants (VLBWIs) sometimes induces serious clinical symptoms. Although breast milk is considered a major source of transmission, transfusion\u2010transmitted CMV (TT\u2010CMV) infection is often suspected when CMV disease develops after transfusion. Thus, it is clinically important to distinguish between transfusion\u2010transmitted and breast milk\u2013transmitted CMV infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN AND METHODS<\/jats:title><jats:p>Study A: The incidence of acquired CMV transmission was prospectively investigated in 65 VLBWIs. Study B: To determine the transmission routes in 18 TT\u2010CMV\u2013suspected VLBWIs who had been reported in our hemovigilance system, we performed polymerase chain reaction for CMV DNA in fed breast milk and\/or repository blood samples related to transfused leukoreduced blood products. Furthermore, we evaluated the identity of CMV strains in patients' urine\/blood samples and fed breast milk by sequence analyses of variable CMV genes <jats:italic>UL139<\/jats:italic> and <jats:italic>UL146<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Study A: Acquired CMV infection was found in 4 of 65 VLBWIs (6.2%). Study B: CMV DNA was detected in fed breast milk for 12 of 14 TT\u2010CMV\u2013suspected cases, for which breast milk was available. Furthermore, CMV DNA sequence\u2010matching rates between fed breast milk and patients' urine\/blood for both <jats:italic>UL139<\/jats:italic> and <jats:italic>UL146<\/jats:italic> genes were 100% or nearly 100% in 11 patients. In contrast, repository blood samples for 11 of 14 patients were CMV DNA negative.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>CMV is principally transmitted through breast milk in VLBWIs. The risk of TT\u2010CMV seems to be extremely low when using leukoreduced blood products. Sequence analyses of the variable CMV genes are useful for evaluating CMV transmission routes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.14920","type":"journal-article","created":{"date-parts":[[2018,10,19]],"date-time":"2018-10-19T10:34:34Z","timestamp":1539945274000},"page":"2894-2902","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Sequence analyses of variable cytomegalovirus genes for distinction between breast milk\u2013 and transfusion\u2010transmitted infections in very\u2010low\u2010birth\u2010weight infants"],"prefix":"10.1111","volume":"58","author":[{"given":"Yasumi","family":"Furui","sequence":"first","affiliation":[{"name":"Blood Service Headquarters Japanese Red Cross Society Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoji","family":"Yamagishi","sequence":"additional","affiliation":[{"name":"Central Blood Institute, Japanese Red Cross Society  Tokyo 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