{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T18:27:34Z","timestamp":1749061654166},"reference-count":21,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,11,25]],"date-time":"2015-11-25T00:00:00Z","timestamp":1448409600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Despite increasing evidence in favor of prophylactic valganciclovir treatment in kidney transplant recipients for the prevention of cytomegalovirus (<jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content>) infection, the impact of preemptive vs. prophylactic treatment on long\u2010term clinical outcomes is unclear. In this retrospective study, 187 kidney transplant recipients with serologic intermediate\u2010risk constellation (recipient <jats:styled-content style=\"fixed-case\">CMV I<\/jats:styled-content>g<jats:styled-content style=\"fixed-case\">G<\/jats:styled-content> positive) received either preemptive or prophylactic treatment with valganciclovir. Patient survival (primary endpoint), graft survival, viremia rates, and other <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content>\u2010related outcomes were analyzed. Prophylactic therapy reduced the rates for <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> viremia during the first year (hazard ratio: 0.48, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 0.30\u20130.75; p &lt; 0.001). There was a trend for higher three\u2010yr patient mortality in the prophylactic group (hazard ratio: 5.08, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.62\u201341.3; p = 0.091), and the rate of graft loss was not reduced (hazard ratio: 0.93, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.32\u20132.68; p = 0.894). Estimated glomerular filtration rate over three yr was on average 6.8 mL\/min\/1.73 m<jats:sup>2<\/jats:sup> lower in the prophylactic group (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u221211.68 to \u22121.81; p = 0.007) using a multivariate random effects model but showed more improvement over time. Prophylactic valganciclovir treatment reduced the rate of <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> infections during the first year post\u2010transplant but no effects of prophylactic treatment on patient and graft survival or kidney function over three yr were observed.<\/jats:p>","DOI":"10.1111\/ctr.12657","type":"journal-article","created":{"date-parts":[[2015,10,13]],"date-time":"2015-10-13T21:48:35Z","timestamp":1444772915000},"page":"1230-1238","source":"Crossref","is-referenced-by-count":8,"title":["Prophylactic <scp>CMV<\/scp> therapy does not improve three\u2010yr patient and graft survival compared to preemptive therapy"],"prefix":"10.1111","volume":"29","author":[{"given":"Johannes","family":"Werzowa","sequence":"first","affiliation":[{"name":"Clinical Division of Nephrology and Dialysis Department of Medicine 3 Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benedikt","family":"Schwaiger","sequence":"additional","affiliation":[{"name":"Clinical Division of Nephrology and Dialysis Department of Medicine 3 Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manfred","family":"Hecking","sequence":"additional","affiliation":[{"name":"Clinical Division of Nephrology and Dialysis Department of Medicine 3 Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Strassl","sequence":"additional","affiliation":[{"name":"Division of Clinical Virology Department of Laboratory Medicine Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabine","family":"Schmaldienst","sequence":"additional","affiliation":[{"name":"Department of Medicine 1 Kaiser\u2010Franz\u2010Josef\u2010Spital Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georg A.","family":"B\u00f6hmig","sequence":"additional","affiliation":[{"name":"Clinical Division of Nephrology and Dialysis Department of Medicine 3 Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernd","family":"Genser","sequence":"additional","affiliation":[{"name":"Mannheim Institute of Public Health, Social and Preventive Medicine University of Heidelberg Heidelberg Germany"},{"name":"BGStats Consulting Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus D.","family":"S\u00e4emann","sequence":"additional","affiliation":[{"name":"Clinical Division of Nephrology and Dialysis Department of Medicine 3 Medical University of Vienna Vienna 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