{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T13:56:28Z","timestamp":1764251788656,"version":"3.41.2"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T00:00:00Z","timestamp":1667952000000},"content-version":"vor","delay-in-days":0,"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":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Induction therapy has been increasingly used in pediatric heart transplantation. This study evaluated the impact of anti\u2010thymocyte globulin (ATG) versus basiliximab as induction therapy on post\u2010transplant cytomegalovirus (CMV) infection, rejection at 1 year, coronary allograft vasculopathy (CAV), and mortality in pediatric heart transplant recipients receiving antiviral prophylaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 96 patients (age\u00a0&lt;\u00a018 years) analyzed, 46 (47.9%) patients received basiliximab, and 50 (52.1%) received ATG. Median follow\u2010up was 3.0 (IQR, 1.7\u20134.9) years with 32.3% reporting CMV infection. The ATG group, as compared with the basiliximab group, had similar incidences of CMV infection (36%\u00a0vs. 28.3%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.418), CMV viremia (22%\u00a0vs. 19.6%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.769), and CMV\u2010positive tissue biopsy (30%\u00a0vs. 22%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.486). The ATG group had lower incidences of rejection at 1 year (16%\u00a0vs. 36.9%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.022) and CAV (4%\u00a0vs. 23.9%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.006) with no difference in mortality (8% vs. 15.2%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.343), compared with the basiliximab group. Multivariate analysis showed that induction with ATG was associated with a lower risk of rejection at 1 year (OR, .31; 95% CI, .09\u2013.94; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.039) with no impact on the incidences of CMV infection (HR, 2.06; 95% CI, .54\u20137.89; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.292), CAV (HR, .30; 95% CI, .04\u20132.58; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.275), and mortality (HR, .39; 95% CI, .09\u20131.82; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.233) compared to basiliximab induction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and conclusions<\/jats:title><jats:p>In conclusion, induction with ATG was associated with reduction in risk of rejection at 1 year with no effects on CMV infection, CAV, and mortality in pediatric heart transplant recipients with universal antiviral prophylaxis compared with basiliximab induction therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.14836","type":"journal-article","created":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T11:08:52Z","timestamp":1666177732000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Impact of induction therapy on cytomegalovirus infection and post\u2010transplant outcomes in pediatric heart transplant recipients receiving routine antiviral prophylaxis"],"prefix":"10.1111","volume":"37","author":[{"given":"Suhua","family":"Zang","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery the First Affiliated Hospital of Zhengzhou University  Zhengzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery the First Affiliated Hospital of Zhengzhou University  Zhengzhou 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