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We report a descriptive case series of 15 patients who had documented <jats:styled-content style=\"fixed-case\">GR<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> at our center and review the literature on treatment of <jats:styled-content style=\"fixed-case\">GR<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content>. The first case in this series was detected in 2012; the majority of cases occurred after January 1, 2014, with approximately 50% occurring in 2015. <jats:styled-content style=\"fixed-case\">UL<\/jats:styled-content>97 and <jats:styled-content style=\"fixed-case\">UL<\/jats:styled-content>54 viral genome mutations were present in 100% and 40% of <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content>\u2010infected patients, respectively. <jats:styled-content style=\"fixed-case\">GR<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> infection occurred \u2264 1 year posttransplantation in 11 patients (73%). All patients experienced dose reduction of valganciclovir (the oral prodrug of ganciclovir) before the development of <jats:styled-content style=\"fixed-case\">GR<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content>. Initial treatment for <jats:styled-content style=\"fixed-case\">GR<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> included a variety of regimens, all including reduction in maintenance immunosuppression. Of the 6 patients with detectable <jats:styled-content style=\"fixed-case\">GR<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> by polymerase chain reaction (<jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content>) who were discharged without <jats:styled-content style=\"fixed-case\">GR<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> treatment and had a length of stay (<jats:styled-content style=\"fixed-case\">LOS<\/jats:styled-content>) less than 14 days, 83% were subsequently readmitted for treatment of <jats:styled-content style=\"fixed-case\">GR<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> within 2 months (60% in &lt; 20 days); none received leflunomide. Of six patients with a <jats:styled-content style=\"fixed-case\">LOS<\/jats:styled-content> \u2265 14 days, 80% had <jats:styled-content style=\"fixed-case\">CMV PCR<\/jats:styled-content> below quantification on hospital discharge, and only one patient was readmitted in less than 20 days; 83% received leflunomide. Following <jats:styled-content style=\"fixed-case\">GR<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content>, there was a 50% rejection incidence, 27% graft loss, and 20% mortality. For patients with more than three admissions for <jats:styled-content style=\"fixed-case\">GR<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> treatment, 100% had a major complication: 60% rejection, 20% graft loss, and 40% mortality. Common clinical characteristics of patients with <jats:styled-content style=\"fixed-case\">GR<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> included high\u2010risk serostatus, lymphocyte depletion, and history of valganciclovir dose reduction. Overall, outcomes were poor. It appears that hospital readmission rate was reduced when <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> was treated to negativity with an initial treatment regimen of reduced immunosuppression, foscarnet, intravenous immunoglobulins, and leflunomide.<\/jats:p>","DOI":"10.1002\/phar.1987","type":"journal-article","created":{"date-parts":[[2017,7,12]],"date-time":"2017-07-12T04:52:41Z","timestamp":1499835161000},"page":"1258-1271","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Ganciclovir\u2010Resistant Cytomegalovirus Infection in Abdominal Solid Organ Transplant Recipients: Case Series and Review of the Literature"],"prefix":"10.1002","volume":"37","author":[{"given":"Katherine E.","family":"Rolling","sequence":"first","affiliation":[{"name":"University of Wisconsin\u2010Madison School of Pharmacy Madison Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret 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