{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:53:18Z","timestamp":1792810398659,"version":"4.5.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T00:00:00Z","timestamp":1689811200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n            <jats:title>Background.<\/jats:title>\n            <jats:p>Following kidney transplantation (KT), cytomegalovirus (CMV) infection remains an important challenge. Both prophylactic and preemptive antiviral protocols are used for CMV high-risk kidney recipients (donor seropositive\/recipient seronegative; D+\/R\u2013). We performed a nationwide comparison of the 2 strategies in de novo D+\/R\u2013 KT recipients accessing long-term outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods.<\/jats:title>\n            <jats:p>A nationwide retrospective study was conducted from 2007 to 2018, with follow-up until February 1, 2022. All adult D+\/R\u2013 and R+ KT recipients were included. During the first 4 y, D+\/R\u2013 recipients were managed preemptively, changing to 6 mo of valganciclovir prophylaxis from 2011. To adjust for the 2 time eras, de novo intermediate-risk (R+) recipients, who received preemptive CMV therapy throughout the study period, served as longitudinal controls for possible confounders.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results.<\/jats:title>\n            <jats:p>A total of 2198 KT recipients (D+\/R\u2013, n\u2009=\u2009428; R+, n\u2009=\u20091770) were included with a median follow-up of 9.4 (range, 3.1\u201315.1) y. As expected, a greater proportion experienced a CMV infection in the preemptive era compared with the prophylactic era and with a shorter time from KT to CMV infection (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009&lt;\u20090.001). However, there were no differences in long-term outcomes such as patient death (47\/146 [32%] versus 57\/282 [20%]; <jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.3), graft loss (64\/146 [44%] versus 71\/282 [25%]; <jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.5), or death censored graft loss (26\/146 [18%] versus 26\/282 [9%]; <jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.9) in the preemptive versus prophylactic era. Long-term outcomes in R+ recipients showed no signs of sequential era\u2013related bias.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions.<\/jats:title>\n            <jats:p>There were no significant differences in relevant long-term outcomes between preemptive and prophylactic CMV-preventive strategies in D+\/R\u2013 kidney transplant recipients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/tp.0000000000004615","type":"journal-article","created":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T04:00:35Z","timestamp":1684728035000},"page":"1846-1853","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":21,"title":["Cytomegalovirus High-risk Kidney Transplant Recipients Show No Difference in Long-term Outcomes Following Preemptive Versus Prophylactic Management"],"prefix":"10.1097","volume":"107","author":[{"given":"Kjersti B.","family":"Blom","sequence":"first","affiliation":[{"name":"Department of Nephrology, Oslo University Hospital, Ullev\u00e5l, Oslo, Norway."},{"name":"Institute for Experimental Medical Research, KG Jebsen Center for Cardiac Research, Oslo University Hospital, Ullev\u00e5l and University of Oslo, Oslo, Norway."},{"name":"Faculty of Medicine, University of Oslo, Oslo, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grete K.","family":"Birkeland","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Oslo University Hospital, Oslo, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karsten","family":"Midtvedt","sequence":"additional","affiliation":[{"name":"Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trond G.","family":"Jenssen","sequence":"additional","affiliation":[{"name":"Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway."},{"name":"Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna V.","family":"Reis\u00e6ter","sequence":"additional","affiliation":[{"name":"Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halvor","family":"Rollag","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Hartmann","sequence":"additional","affiliation":[{"name":"Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solbj\u00f8rg","family":"Sagedal","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Oslo University Hospital, Ullev\u00e5l, Oslo, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivar","family":"Sjaastad","sequence":"additional","affiliation":[{"name":"Institute for Experimental Medical Research, KG Jebsen Center for Cardiac Research, Oslo University Hospital, Ullev\u00e5l and University of Oslo, Oslo, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garth","family":"Tylden","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Infection Control, University Hospital of North Norway, Troms\u00f8, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gro","family":"Nj\u00f8lstad","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Haukeland University Hospital, Bergen, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Einar","family":"Nilsen","sequence":"additional","affiliation":[{"name":"Department of Microbiology, M\u00f8re and Romsdal Hospital Trust, Molde, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Christensen","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"\u00c5sberg","sequence":"additional","affiliation":[{"name":"Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway."},{"name":"The Norwegian Renal Registry, Oslo University Hospital, Rikshospitalet, Oslo, Norway."},{"name":"Department of Pharmacy, University of Oslo, Oslo, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon A.","family":"Birkeland","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Oslo University Hospital, Ullev\u00e5l, Oslo, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,7,20]]},"reference":[{"key":"R1-20250604","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1111\/j.1523-1755.2004.00735.x","article-title":"Impact of early cytomegalovirus infection and disease on long-term recipient and kidney graft survival.","volume":"66","author":"Sagedal","year":"2004","journal-title":"Kidney Int"},{"key":"R2-20250604","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1111\/ctr.12288","article-title":"The impact of early cytomegalovirus infection after kidney transplantation on long-term graft and patient survival.","volume":"28","author":"Smedbr\u00e5ten","year":"2014","journal-title":"Clin 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analyses.","volume":"13","author":"Toupance","year":"2000","journal-title":"Transpl Int"},{"key":"R6-20250604","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1034\/j.1600-6143.2002.20907.x","article-title":"The impact of cytomegalovirus infection and disease on rejection episodes in renal allograft recipients.","volume":"2","author":"Sagedal","year":"2002","journal-title":"Am J Transplant"},{"key":"R7-20250604","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1007\/s00125-004-1499-z","article-title":"Asymptomatic cytomegalovirus infection is associated with increased risk of new-onset diabetes mellitus and impaired insulin release after renal transplantation.","volume":"47","author":"Hjelmesaeth","year":"2004","journal-title":"Diabetologia"},{"key":"R8-20250604","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":"R9-20250604","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1093\/cid\/cit945","article-title":"A direct and indirect comparison meta-analysis on the efficacy of cytomegalovirus preventive strategies in solid organ transplant.","volume":"58","author":"Florescu","year":"2014","journal-title":"Clin Infect Dis"},{"key":"R10-20250604","doi-asserted-by":"crossref","first-page":"2134","DOI":"10.1111\/j.1600-6143.2006.01413.x","article-title":"Prophylactic versus preemptive oral valganciclovir for the management of cytomegalovirus infection in adult renal transplant recipients.","volume":"6","author":"Khoury","year":"2006","journal-title":"Am J Transplant"},{"key":"R11-20250604","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1097\/TP.0000000000002024","article-title":"Valganciclovir prophylaxis versus preemptive therapy in cytomegalovirus-positive renal allograft recipients: long-term results after 7 years of a randomized clinical trial.","volume":"102","author":"Witzke","year":"2018","journal-title":"Transplantation"},{"key":"R12-20250604","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1111\/j.1399-3062.2011.00652.x","article-title":"Preemptive versus prophylactic protocol to prevent cytomegalovirus infection after renal transplantation: a meta-analysis and systematic review of randomized controlled trials.","volume":"13","author":"Zhang","year":"2011","journal-title":"Transpl Infect Dis"},{"key":"R13-20250604","doi-asserted-by":"crossref","first-page":"e13016","DOI":"10.1111\/tid.13016","article-title":"Comparison of universal prophylaxis and preemptive approach for cytomegalovirus associated outcome measures in renal transplant patients: a meta-analysis of available data.","volume":"21","author":"Caskurlu","year":"2019","journal-title":"Transpl Infect Dis"},{"key":"R14-20250604","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1111\/j.1432-2277.2010.01101.x","article-title":"Pre-emptive intravenous ganciclovir versus valganciclovir prophylaxis for de novo cytomegalovirus-seropositive kidney-transplant recipients.","volume":"23","author":"Weclawiak","year":"2010","journal-title":"Transpl Int"},{"key":"R15-20250604","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1111\/ctr.12657","article-title":"Prophylactic CMV therapy does not improve three-yr patient and graft survival compared to preemptive therapy.","volume":"29","author":"Werzowa","year":"2015","journal-title":"Clin Transplant"},{"key":"R16-20250604","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1111\/tri.12586","article-title":"Cytomegalovirus prevention strategies in seropositive kidney transplant recipients: an insight into current clinical practice.","volume":"28","author":"Fern\u00e1ndez-Ruiz","year":"2015","journal-title":"Transpl Int"},{"key":"R17-20250604","first-page":"10","article-title":"A systematic review and meta-analysis of prophylactic versus pre-emptive strategies for preventing cytomegalovirus infection in renal transplant recipients.","volume":"3","author":"Rawal","year":"2012","journal-title":"Int J Organ Transplant Med"},{"key":"R18-20250604","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/j.transproceed.2017.01.027","article-title":"Impact of prophylaxis vs pre-emptive approach for cytomegalovirus infection in kidney transplant recipients.","volume":"49","author":"Kir","year":"2017","journal-title":"Transplant Proc"},{"key":"R19-20250604","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1097\/TP.0b013e318238dab3","article-title":"Valganciclovir prophylaxis versus preemptive therapy in cytomegalovirus-positive renal allograft recipients: 1-year results of a randomized clinical 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Med"},{"key":"R23-20250604","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":"R24-20250604","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/TP.0b013e3181ff8719","article-title":"The clinical utility of whole blood versus plasma cytomegalovirus viral load assays for monitoring therapeutic response.","volume":"91","author":"Lisboa","year":"2011","journal-title":"Transplantation"},{"key":"R25-20250604","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1093\/cid\/cit096","article-title":"Virologic suppression measured by a cytomegalovirus (CMV) DNA test calibrated to the World Health Organization international standard is predictive of CMV disease resolution in transplant recipients.","volume":"56","author":"Razonable","year":"2013","journal-title":"Clin Infect Dis"},{"key":"R26-20250604","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1111\/nep.12738","article-title":"Low-target tacrolimus in de novo standard risk renal transplant recipients: a single-centre experience.","volume":"21","author":"St\u00f8rset","year":"2016","journal-title":"Nephrology (Carlton)"},{"key":"R28-20250604","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1111\/j.1600-6143.2007.02133.x","article-title":"Improvement in long-term renal graft survival due to CMV prophylaxis with oral ganciclovir: results of a randomized clinical trial.","volume":"8","author":"Kliem","year":"2008","journal-title":"Am J Transplant"},{"key":"R29-20250604","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.1681\/ASN.2012010100","article-title":"Long-term outcomes of pre-emptive valganciclovir compared with valacyclovir prophylaxis for prevention of cytomegalovirus in renal transplantation.","volume":"23","author":"Reischig","year":"2012","journal-title":"J Am Soc Nephrol"},{"key":"R30-20250604","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1111\/j.1600-6143.2007.02031.x","article-title":"Valacyclovir prophylaxis versus preemptive valganciclovir therapy to prevent cytomegalovirus disease after renal transplantation.","volume":"8","author":"Reischig","year":"2008","journal-title":"Am J 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