{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:27:13Z","timestamp":1790083633631,"version":"4.0.1"},"reference-count":37,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Cytomegalovirus (CMV) infection remains the most prevalent viral infection in kidney transplant recipients. Despite effective preventive strategies, the use of desensitization therapies and potent immunosuppressive agents in patients with high immunological risks underscores the continued importance of CMV as a major concern. This study aims to determine the incidence and outcomes of CMV infection in patients with diverse immunological risks under preemptive stategies. We analyzed 614 CMV\u2010seropositive kidney transplant recipients managed under preemptive strategies. Of them, 231 patients (37.6%) underwent immunologically incompatible transplantation, including 75 ABO\u2010 and 156 HLA\u2010incompatible transplants. During the median follow\u2010up of 60 months, 354 patients (57.7%) experienced CMV infection. Multivariable analysis identified older recipient age, deceased donor, rituximab, and anti\u2010thymocyte globulin as independent risk factors for CMV infection, while the use of mammalian target of rapamycin inhibitor was protective. Multivariable Cox regression analysis confirmed that CMV infection was independently associated with increased risks of death\u2010censored graft loss (adjusted hazard ratio [aHR], 2.05; 95% confidence interval [CI], 1.17\u20133.59) and all\u2010cause mortality (aHR, 3.40; 95% CI, 1.60\u20137.23). CMV infection adversely affects graft and patient outcomes in seropositive recipients managed under preemptive strategies. These findings emphasize the need for optimized CMV prevention strategies in recipients with high immunological risks, hereby intensified preemptive strategies or immunological risk\u2010adapted antiviral prophylaxis are key options.<\/jats:p>","DOI":"10.1002\/jmv.70474","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T09:11:20Z","timestamp":1750929080000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cytomegalovirus Infection in Seropositive Kidney Transplant Recipients With Diverse Immunological Risks Under Preemptive Strategy"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2708-0755","authenticated-orcid":false,"given":"Mun Chae","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Surgery Armed Forces Capital Hospital Seongnam South Korea"},{"name":"Department of Surgery, Graduate School Yonsei University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6623-2774","authenticated-orcid":false,"given":"Minyu","family":"Kang","sequence":"additional","affiliation":[{"name":"The Research, Institute for Transplantation Yonsei University College of Medicine Seoul South Korea"},{"name":"Department of Surgery Yonsei University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5944-6136","authenticated-orcid":false,"given":"Hwa\u2010hee","family":"Koh","sequence":"additional","affiliation":[{"name":"The Research, Institute for Transplantation Yonsei University College of Medicine Seoul South Korea"},{"name":"Department of Surgery Yonsei University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2146-3592","authenticated-orcid":false,"given":"Seung Hyuk","family":"Yim","sequence":"additional","affiliation":[{"name":"Department of Surgery Yonsei University College of Medicine Seoul South Korea"},{"name":"Department of Surgery Yongin Severance Hospital Gyeonggi\u2010do South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6033-5094","authenticated-orcid":false,"given":"Hyun Jeong","family":"Kim","sequence":"additional","affiliation":[{"name":"The Research, Institute for Transplantation Yonsei University College of Medicine Seoul South Korea"},{"name":"Department of Surgery Yonsei University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4025-4542","authenticated-orcid":false,"given":"Su Jin","family":"Jung","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Department of Internal Medicine Yonsei University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6305-452X","authenticated-orcid":false,"given":"Hyung Woo","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine Yonsei University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5378-7797","authenticated-orcid":false,"given":"Jaeseok","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine Yonsei University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5732-2583","authenticated-orcid":false,"given":"Beom Seok","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine Yonsei University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1364-6989","authenticated-orcid":false,"given":"Kyu Ha","family":"Huh","sequence":"additional","affiliation":[{"name":"The Research, Institute for Transplantation Yonsei University College of Medicine Seoul South Korea"},{"name":"Department of Surgery Yonsei University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8975-8381","authenticated-orcid":false,"given":"Myoung Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"The Research, Institute for Transplantation Yonsei University College of Medicine Seoul South Korea"},{"name":"Department of Surgery Yonsei University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4910-2596","authenticated-orcid":false,"given":"Juhan","family":"Lee","sequence":"additional","affiliation":[{"name":"The Research, Institute for Transplantation Yonsei University College of Medicine Seoul South Korea"},{"name":"Department of Surgery Yonsei University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12006"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000004297"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000000160"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12103"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trim.2022.101677"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002191"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.4285\/kjt.22.0036"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae321"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfw017"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2022.11.016"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15480"},{"issue":"4","key":"e_1_2_9_13_1","first-page":"367","article-title":"Induction Immunosuppression in High\u2010Risk Kidney Transplant Recipients","volume":"14","author":"Buttigieg J.","year":"2016","journal-title":"Experimental and Clinical Transplantation: Official Journal of the Middle East Society for Organ Transplantation"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/13.3.711"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/tri.12043"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.12977"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000003124"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-200102150-00021"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000004279"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trim.2023.101899"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15913"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-007-0397-0"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428190701411441"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/hon.2453"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03710411"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1159\/000475888"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12601"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/eji.202048855"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature08155"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2018010009"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2019.01.041"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13327"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.0000000000000090"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2006.01413.x"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2007.02031.x"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15183"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjid.2016.08.007"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2017.09.023"}],"container-title":["Journal of Medical Virology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.70474","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jmv.70474","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.70474","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T13:51:57Z","timestamp":1780062717000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmv.70474"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,26]]},"references-count":37,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1002\/jmv.70474"],"URL":"https:\/\/doi.org\/10.1002\/jmv.70474","archive":["Portico"],"relation":{},"ISSN":["0146-6615","1096-9071"],"issn-type":[{"value":"0146-6615","type":"print"},{"value":"1096-9071","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,26]]},"assertion":[{"value":"2025-03-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70474"}}