{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T18:59:33Z","timestamp":1773687573467,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,10,8]],"date-time":"2019-10-08T00:00:00Z","timestamp":1570492800000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To describe the incidence of cytomegalovirus (CMV) infection\/disease in kidney transplant recipients receiving an mTOR\u2010inhibitor\u2010containing immunosuppressive regimen without prophylactic CMV treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This single\u2010center retrospective cohort analysis included all de novo kidney transplant recipients (09\/15\/2015\u201007\/31\/2017) receiving 3\u00a0mg\/kg single dose of rabbit antithymocyte globulin induction, tacrolimus, everolimus, and prednisone. Preemptive therapy was initiated only in patients deemed at higher risk for CMV infection: (a) D+\/R\u2212 CMV patients; (b) after treatment for acute rejection (ARt); and (c) after everolimus discontinuation (EVRd).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 230 patients, there were no episodes of CMV disease among 217 (94%) without criteria to initiate preemptive therapy. Of 77 (33.5%) patients initiating preemptive therapy, 13 were D+\/R\u2212, 30 were ARt, and 34 were EVRd. The overall incidence of first CMV infection\/disease was 6% (46.1% in D+\/R\u2212, 13.3% ARt [all patients had also discontinued everolimus], and 11.8% after early [&lt;90\u00a0days] EVRd). The incidence of biopsy\u2010proven acute rejection was 5.6%, and median glomerular filtration rate at month 12 was 47\u00a0mL\/min\/1.73m<jats:sup>2<\/jats:sup>. One\u2010year patient and death\u2010censored graft survivals were 97.4% and 98.1%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study suggests that everolimus\u2010containing immunosuppressive regimen reduces the need for preventive strategies for CMV infection in the majority of kidney transplant recipients, reducing antiviral drug\u2010associated toxicities and healthcare\u2010related expenditures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.13689","type":"journal-article","created":{"date-parts":[[2019,8,10]],"date-time":"2019-08-10T09:13:34Z","timestamp":1565428414000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Use of mTOR inhibitor as prophylaxis for cytomegalovirus disease after kidney transplantation: A natural experiment"],"prefix":"10.1111","volume":"33","author":[{"given":"Marina Pontelo","family":"Cristelli","sequence":"first","affiliation":[{"name":"Nephrology Division Hospital do Rim, Federal University of S\u00e3o Paulo S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia Rosso","family":"Felipe","sequence":"additional","affiliation":[{"name":"Nephrology Division Hospital do Rim, Federal University of S\u00e3o Paulo S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo Sergio de Souza","family":"Prizmic","sequence":"additional","affiliation":[{"name":"Nephrology Division Hospital do Rim, Federal University of S\u00e3o Paulo S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vega Figueiredo Dourado","family":"de Azevedo","sequence":"additional","affiliation":[{"name":"Nephrology Division Hospital do Rim, Federal University of S\u00e3o Paulo S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laila Almeida","family":"Viana","sequence":"additional","affiliation":[{"name":"Nephrology Division Hospital do Rim, Federal University of S\u00e3o Paulo S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6908-1927","authenticated-orcid":false,"given":"Melissa Gaspar","family":"Tavares","sequence":"additional","affiliation":[{"name":"Nephrology Division Hospital do Rim, Federal University of S\u00e3o Paulo S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Wagner de Castro Lima Santos","sequence":"additional","affiliation":[{"name":"Infectious Disease Division Hospital do Rim, Federal University of S\u00e3o Paulo S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayara Ivani","family":"de Paula","sequence":"additional","affiliation":[{"name":"Nephrology Division Hospital do Rim, Federal University of S\u00e3o Paulo S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose Osmar","family":"Medina\u2010Pestana","sequence":"additional","affiliation":[{"name":"Nephrology Division Hospital do Rim, Federal University of S\u00e3o Paulo S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9896-323X","authenticated-orcid":false,"given":"Helio","family":"Tedesco\u2010Silva Junior","sequence":"additional","affiliation":[{"name":"Nephrology Division Hospital do Rim, Federal University of S\u00e3o Paulo S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,10,8]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002191"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2016.04.001"},{"key":"e_1_2_6_4_1","first-page":"CD003774","article-title":"Antiviral medications 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