{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T10:09:50Z","timestamp":1784282990957,"version":"3.55.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100010391","name":"Tokyo Women's Medical University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100010391","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Exp Nephrol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The optimal dosing strategy for valganciclovir (VGCV) prophylaxis against cytomegalovirus (CMV) infection in pediatric patients after kidney transplantation (KT) remains uncertain because of the narrow therapeutic window between antiviral efficacy and safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study included pediatric patients who received VGCV prophylaxis after KT at a single center between December 2023 and December 2024. VGCV was administered once daily for 200\u00a0days using a reduced-dose regimen. Approximately 50% of the U.S. Food and Drug Administration\u2013recommended dose was used for high-risk patients defined as donor-positive and recipient-negative, and 33% for intermediate-risk patients defined as recipient-positive. The incidence of CMV infection within 200\u00a0days after KT and VGCV-related adverse events (AEs) were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nine patients with a median age of 8\u00a0years were included, with a median observational period of 431\u00a0days after KT. CMV infection within 200\u00a0days occurred in four patients, all of whom were high-risk patients. No CMV disease occurred during the observational period. Neutropenia occurred in six patients, including five high-risk patients and one intermediate-risk patient. Three high-risk patients developed febrile neutropenia. VGCV dose reduction and\/or discontinuation due to hematologic AEs was required in four patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The reduced-dose VGCV prophylaxis regimen was associated with a high incidence of CMV infection and AEs in high-risk patients, indicating a suboptimal balance between efficacy and safety. In intermediate-risk patients, the regimen appeared effective and tolerable. Further optimization of prophylactic strategies is required, particularly for high-risk pediatric recipients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10157-026-02876-z","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T07:22:43Z","timestamp":1778656963000},"page":"1245-1252","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of reduced-dose valganciclovir prophylaxis for cytomegalovirus infection after pediatric kidney transplantation"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3438-0251","authenticated-orcid":false,"given":"Ryo","family":"Nakatani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3734-4766","authenticated-orcid":false,"given":"Yoko","family":"Shirai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taro","family":"Ando","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko","family":"Yamasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yohei","family":"Kume","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Tsugawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Unagami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomokazu","family":"Shimizu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideki","family":"Ishida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9483-8482","authenticated-orcid":false,"given":"Kenichiro","family":"Miura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"2876_CR1","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1111\/j.1432-2277.2006.00364.x","volume":"19","author":"I Helanter\u00e4","year":"2006","unstructured":"Helanter\u00e4 I, Koskinen P, Finne P, et al. 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This study was approved by the Ethics Committee of Tokyo Women\u2019s Medical University (approval No. 5528) and was conducted in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was waived, with an opt-out option provided through public disclosure.","order":3,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}}]}}