{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T12:27:30Z","timestamp":1764937650447,"version":"3.41.2"},"reference-count":128,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T00:00:00Z","timestamp":1701993600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Human\u2010cytomegalovirus (hCMV) infection involving the gastrointestinal tract represents a leading cause of morbidity and mortality among kidney transplant (KT) recipients (KTRs). Signs and symptoms of the disease are extremely variable. Prompt anti\u2010viral therapy administration and immunosuppression modification are key factors for optimizing management. However, complex work\u2010up strategies are generally required to confirm the preliminary diagnosis. Unfortunately, solid evidence and guidelines on this specific topic are not available.<\/jats:p><jats:p>We consequently aimed to summarize current knowledge on post\u2010KT hCMV\u2010related gastrointestinal disease (hCMV\u2010GID).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a systematic review (PROSPERO ID: CRD42023399363) about hCMV\u2010GID in KTRs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our systematic review includes 52 case\u2010reports and ten case\u2010series, published between 1985 and 2022, collectively reporting 311 cases. The most frequently reported signs and symptoms of hCMV\u2010GID were abdominal pain, diarrhea, epigastric pain, vomiting, fever, and GI bleeding. Esophagogastroduodenoscopy and colonoscopy were the primary diagnostic techniques. In most cases, the preliminary diagnosis was confirmed by histology. Information on anti\u2010viral prophylaxis were extremely limited as much as data on induction or maintenance immunosuppression. Treatment included ganciclovir and\/or valganciclovir administration. Immunosuppression modification mainly consisted of mycophenolate mofetil or calcineurin inhibitor minimization and withdrawal. In total, 21 deaths were recorded. Renal allograft\u2010related outcomes were described for 26 patients only. Specifically, reported events were acute kidney injury (<jats:italic>n<\/jats:italic>\u00a0=\u00a017), transplant failure (<jats:italic>n<\/jats:italic>\u00a0=\u00a05), allograft rejection (<jats:italic>n<\/jats:italic>\u00a0=\u00a04), and irreversible allograft dysfunction (<jats:italic>n<\/jats:italic>\u00a0=\u00a03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The development of local and national registries is strongly recommended to improve our understanding of hCMV\u2010GID. Future clinical guidelines should consider the implementation of dedicated diagnostic and treatment strategies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.15218","type":"journal-article","created":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T15:41:32Z","timestamp":1702050092000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Human cytomegalovirus\u2010related gastrointestinal disease after kidney transplantation: A systematic review"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4085-1884","authenticated-orcid":false,"given":"Ilaria Elena","family":"Zais","sequence":"first","affiliation":[{"name":"School of Medicine Universit\u00e0 degli Studi di Milano  Milan 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