{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T17:26:40Z","timestamp":1764350800808,"version":"3.41.2"},"reference-count":34,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T00:00:00Z","timestamp":1682553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008373","name":"Takeda Pharmaceutical Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008373","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>This study aimed to characterize patient risk groups and respective prognostic profiles to optimize clinical decision\u2010making and guide appropriate medical cytomegalovirus (CMV) management among patients with solid organ transplant (SOT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between September 2021 and February 2022, a three\u2010round modified Delphi study was conducted to generate consensus among 14 international experts in virology and organ transplantation. Experts were asked about treatment and prognoses for patients in seven distinct clinical scenarios. Furthermore, experts were asked to risk\u2010stratify patients by pre\u2010\/post\u2010transplant characteristics. Consensus around opting for\/against a treatment was observed if \u226575% or &lt;25% of experts reported \u226550% likelihood to recommend or if treatments were ranked inside\/outside the top two options and \u226575% of experts were within 1 standard deviation of the mean rank.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Experts agreed on several unmet needs in CMV disease management post\u2010SOT, particularly avoidance of treatment\u2010limiting toxicities with conventional CMV therapy and emergence of both primary refractory and drug resistant treatment failures. Experts considered CMV viral load, resistance profile, and route of administration as critical to treatment selection. For newer CMV therapeutic options, experts listed lack of long\u2010term use data, concerns over potential resistance, high cost and limited availability as challenges restricting adoption, and successful patient management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Experts achieved consensus around patient risk stratifications and factors influencing therapeutic options. Recommendations emerging from this Delphi study may support practicing physicians when confronted with challenging CMV scenarios in SOT patients, but additional experiences with newer anti\u2010CMV agents are needed to re\u2010validate expert consensus and update post\u2010transplant CMV guidelines.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.14905","type":"journal-article","created":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T21:08:27Z","timestamp":1672952907000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Gaining consensus around patient risk groups and prognostic profiles to guide CMV management among patients with solid organ transplant: Insights from a Delphi panel with SOT experts"],"prefix":"10.1111","volume":"37","author":[{"given":"Priti","family":"Pednekar","sequence":"first","affiliation":[{"name":"PRECISIONheor  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marlon","family":"Graf","sequence":"additional","affiliation":[{"name":"PRECISIONheor  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rifat","family":"Tuly","sequence":"additional","affiliation":[{"name":"PRECISIONheor  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharine","family":"Batt","sequence":"additional","affiliation":[{"name":"Sprouts Consulting, Ltd.  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