Opening Remarks 1

The destiny of final progress and summary reports of research grants and research contracts has always been a mystery to me. Somehow I suspect that many of them end up in dark oblivion in the back of some drawer at the National Institutes of Health. Unless the work is published, the results may be born to die unheard by the scientific community. The occasion for this symposium today is to reverse that trend. In 1971, the National Blood Resource Program of the National Heart and Lung Institute put out a request for a proposal entitled "Epidemiology and Development of Detection Systems for Cytomegalovirus as Transmitted by Blood Transfusion." The purpose of the contract was well stated in the background information. "The dilemma for the epidemiologist is clear; the data at present are inconclusive as to whether cytomegalovirus infection results from transmission by transfused blood, or by activation of latent virus in the recipient, secondary stimulation by foreign white cells, drugs, the stress of surgery, or other causes. Also, presently available detection systems may not be adequate for definitively resolving this dilemma." For the past three years, the group of NIH contractors assembled here have been trying to find some of the answers to this problem. This symposium constitutes their final progress report. The main objective of today's reports are: (1) to portray the current status of the problems of cytomegalovirus in blood transfusions; (2) to summarize the direction and accomplishments of the work of the contractors, and (3) to indicate unresolved problems and possible research approaches for their solution. While each of the different contractors worked on several aspects of the problems during the past three years, each has undertaken to review one of the major issues in the discussion today. Additional work by other contractors contributing to the same issue may emerge during the discussion period, and there are a number of short presentations in this regard. As this is not a closed meeting but has been advertized to the scientific community, there may be others in the audience who have also worked with cytomegalovirus infection and who may wish to make short presentations. The patient in today's modern transplant surgery faces three sources of risk to cytomegalovirus infection: the blood donor, the transplanted organ, and the reactivation of his or her own latent cytomegalovirus infection. The last of these, reactivation, may depend not only on the presence of the virus in the recipient but on graft versus host mechanisms activated by transfused blood or by the transplanted organ, or, most probably, by the immunosuppressive drugs that are used to prevent rejection of the transplant. The papers to be presented address themselves to these issues. Finally, I would like to say that it has been my pleasure to have served as chairman of