{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T04:16:49Z","timestamp":1790482609327,"version":"4.1.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T00:00:00Z","timestamp":1730678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases at the National Institutes of Health","doi-asserted-by":"publisher","award":["AI16390"],"award-info":[{"award-number":["AI16390"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Successful prevention and treatment of cytomegalovirus (CMV) infection remains a central focus of clinical care in solid organ transplantation (SOT) and allogeneic hematopoietic cell transplantation (HCT). Over the past 5 years, pivotal clinical trials have created new paradigms in CMV prevention, including diverging approaches in HCT and SOT. We review recent advances in CMV risk assessment and progress in antiviral and immune-based strategies for CMV prevention and treatment. We highlight approaches to optimize CMV-specific immunity through vaccination, monoclonal antibodies, and virus-specific T cells. Observational studies and interventional trials of commercially available CMV cell-mediated immunity assays for refining preventive and treatment strategies are summarized. Finally, we discuss the importance of enhancing CMV-specific immunity to mitigate the negative impacts of CMV in different transplant settings. CMV infections in recipients of chimeric antigen receptor-T (CAR-T) cell therapies and other immunocompromised populations are growing areas of importance that are beyond the scope of this review.<\/jats:p>","DOI":"10.1093\/cid\/ciae535","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T16:18:47Z","timestamp":1730305127000},"page":"581-592","source":"Crossref","is-referenced-by-count":20,"title":["Current and Future Strategies for the Prevention and Treatment of Cytomegalovirus Infections in Transplantation"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9424-1870","authenticated-orcid":false,"given":"Madeleine R","family":"Heldman","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine , Durham, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1538-7984","authenticated-orcid":false,"given":"Michael J","family":"Boeckh","sequence":"additional","affiliation":[{"name":"Division of Allergy and Infectious Diseases Division, Department of Medicine, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center , Seattle, Washington ,","place":["USA"]},{"name":"Clinical Research Division, Fred Hutchinson Cancer Center , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5350-9025","authenticated-orcid":false,"given":"Ajit P","family":"Limaye","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of California San Francisco , San Francisco, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,11,4]]},"reference":[{"key":"2025100602573796100_ciae535-B1","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1097\/TP.0000000000002191","article-title":"The third international consensus guidelines on the management of cytomegalovirus in solid-organ transplantation","volume":"102","author":"Kotton","year":"2018","journal-title":"Transplantation"},{"key":"2025100602573796100_ciae535-B2","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1097\/TP.0000000000004352","article-title":"Increasing proportion of high-risk cytomegalovirus donor-positive\/recipient-negative serostatus in solid organ transplant recipients.","volume":"107","author":"Imlay","year":"2023","journal-title":"Transplantation"},{"key":"2025100602573796100_ciae535-B3","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1016\/j.jtct.2021.05.001","article-title":"American Society for Transplantation and Cellular Therapy Series: #3\u2014prevention of cytomegalovirus infection and disease after hematopoietic cell transplantation","volume":"27","author":"Hakki","year":"2021","journal-title":"Transplant Cell Ther"},{"key":"2025100602573796100_ciae535-B4","doi-asserted-by":"crossref","first-page":"e13512","DOI":"10.1111\/ctr.13512","article-title":"Cytomegalovirus in solid organ transplant recipients\u2014guidelines of the American Society of Transplantation Infectious Diseases Community of Practice","volume":"33","author":"Razonable","year":"2019","journal-title":"Clin Transplant"},{"key":"2025100602573796100_ciae535-B5","doi-asserted-by":"crossref","first-page":"1378","DOI":"10.1001\/jama.2020.3138","article-title":"Effect of preemptive therapy vs antiviral prophylaxis on cytomegalovirus disease in seronegative liver transplant recipients with seropositive donors: a randomized clinical trial","volume":"323","author":"Singh","year":"2020","journal-title":"JAMA"},{"key":"2025100602573796100_ciae535-B6","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1001\/jama.2023.9106","article-title":"Letermovir vs valganciclovir for prophylaxis of cytomegalovirus in high-risk kidney transplant recipients: a randomized clinical trial","volume":"330","author":"Limaye","year":"2023","journal-title":"JAMA"},{"key":"2025100602573796100_ciae535-B7","doi-asserted-by":"crossref","first-page":"2433","DOI":"10.1056\/NEJMoa1706640","article-title":"Letermovir prophylaxis for cytomegalovirus in hematopoietic-cell transplantation","volume":"377","author":"Marty","year":"2017","journal-title":"N Engl J Med"},{"key":"2025100602573796100_ciae535-B8","doi-asserted-by":"crossref","first-page":"e00043-19","DOI":"10.1128\/CMR.00043-19","article-title":"Progress and challenges in the prevention, diagnosis, and management of cytomegalovirus infection in transplantation","volume":"34","author":"Limaye","year":"2020","journal-title":"Clin Microbiol Rev"},{"key":"2025100602573796100_ciae535-B9","doi-asserted-by":"crossref","first-page":"3639","DOI":"10.1182\/bloodadvances.2023012175","article-title":"Late cytomegalovirus disease after hematopoietic cell transplantation: significance of novel transplantation techniques","volume":"8","author":"Sadowska-Klasa","year":"2024","journal-title":"Blood Adv"},{"key":"2025100602573796100_ciae535-B10","doi-asserted-by":"crossref","first-page":"ofac687","DOI":"10.1093\/ofid\/ofac687","article-title":"Real-world outcomes associated with letermovir use for cytomegalovirus primary prophylaxis in allogeneic hematopoietic cell transplant recipients: a systematic review and meta-analysis of observational studies","volume":"10","author":"Vyas","year":"2023","journal-title":"Open Forum Infect Dis"},{"key":"2025100602573796100_ciae535-B11","doi-asserted-by":"crossref","first-page":"S109","DOI":"10.1093\/infdis\/jiz389","article-title":"The development of therapeutics for the treatment and prevention of CMV disease in the transplant population: a regulatory perspective","volume":"221","author":"Hodowanec","year":"2020","journal-title":"J Infect Dis"},{"key":"2025100602573796100_ciae535-B12","doi-asserted-by":"crossref","first-page":"e1514","DOI":"10.1097\/TXD.0000000000001514","article-title":"A systematic review and meta-analysis of optimized CMV preemptive therapy and antiviral prophylaxis for CMV disease prevention in CMV high-risk (D+R-) kidney transplant recipients","volume":"9","author":"Kumar","year":"2023","journal-title":"Transplant Direct"},{"key":"2025100602573796100_ciae535-B13","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1016\/j.ajt.2024.01.027","article-title":"Association between cytomegalovirus viremia and long-term outcomes in lung transplant 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