{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:47:42Z","timestamp":1787014062724,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T00:00:00Z","timestamp":1711584000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["418043"],"award-info":[{"award-number":["418043"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is variability in recommended viral monitoring protocols after kidney transplant. In response to increased demand for laboratory testing during the COVID\u201019 pandemic, the Transplant Manitoba Adult Kidney Program updated its monitoring protocols for cytomegalovirus (CMV), Epstein\u2010Barr virus (EBV), and BK polyomavirus (BKV) to a reduced frequency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This single\u2010center nested case\u2010control study evaluated 252 adult kidney transplant recipients transplanted from 2015 to 2021, with the updated protocols effective on March 19\n                      <jats:sup>th<\/jats:sup>\n                      2020. Cases included recipients transplanted after the protocol update who developed CMV, EBV, and BKV DNAemia and were matched to controls with DNAemia transplanted prior to the protocol update. The primary outcome was the difference in maximum DNA load titers between cases and matched controls. Secondary outcomes included time to initial DNAemia detection and DNAemia clearance. Safety outcomes of tissue\u2010invasive viral disease were described.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 216 recipients transplanted preupdate and 36 recipients postupdate. There was no difference between cases and controls in maximum or first DNA load titers for EBV, CMV, or BKV. Cases experienced earlier EBV DNAemia detection (26 (IQR 8, 32) vs. 434 (IQR 96, 1184) days,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.005). Median follow\u2010up was significantly longer for recipients transplanted preupdate (4.3\u00a0vs. 1.3 years,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.0001). After adjusting for follow\u2010up time, there was no difference in DNAemia clearance or tissue\u2010invasive viral disease.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings suggest that reduced frequency viral monitoring protocols may be safe and cost\u2010effective. This quality assurance initiative should be extended to detect longer\u2010term and tissue\u2010invasive disease outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.15292","type":"journal-article","created":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T06:21:13Z","timestamp":1711606873000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Safety and efficacy of a reduced frequency viral monitoring strategy for Epstein\u2010Barr virus, cytomegalovirus, and BK polyomavirus post\u2010kidney transplant: A quality assurance initiative"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8040-7908","authenticated-orcid":false,"given":"Christie","family":"Rampersad","sequence":"first","affiliation":[{"name":"University Health Network University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Manitoba  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1006-3545","authenticated-orcid":false,"given":"Chris","family":"Wiebe","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Manitoba  Winnipeg Manitoba Canada"},{"name":"Transplant Manitoba Adult Kidney Program  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Balshaw","sequence":"additional","affiliation":[{"name":"George and Fay Yee Centre for Healthcare Innovation  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared","family":"Bullard","sequence":"additional","affiliation":[{"name":"Cadham Provincial Laboratory  Winnipeg Manitoba Canada"},{"name":"Department of Pediatrics University of Manitoba  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armelle Perez Cortes","family":"Villalobos","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Manitoba  Winnipeg Manitoba Canada"},{"name":"Transplant Manitoba Adult Kidney Program  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8940-5458","authenticated-orcid":false,"given":"Aaron","family":"Trachtenberg","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Manitoba  Winnipeg Manitoba Canada"},{"name":"Transplant Manitoba Adult Kidney Program  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Shaw","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Manitoba  Winnipeg Manitoba Canada"},{"name":"Transplant Manitoba Adult Kidney Program  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Karpinski","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Manitoba  Winnipeg Manitoba Canada"},{"name":"Transplant Manitoba Adult Kidney Program  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7393-7799","authenticated-orcid":false,"given":"Peter W.","family":"Nickerson","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Manitoba  Winnipeg Manitoba Canada"},{"name":"Transplant Manitoba Adult Kidney Program  Winnipeg Manitoba Canada"},{"name":"Department of Immunology University of Manitoba  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8342-9093","authenticated-orcid":false,"given":"Julie","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Manitoba  Winnipeg Manitoba Canada"},{"name":"Transplant Manitoba Adult Kidney Program  Winnipeg Manitoba Canada"},{"name":"Department of Immunology University of Manitoba  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.6061\/clinics\/2015(07)09"},{"key":"e_1_2_8_3_1","first-page":"147","article-title":"Occurrence of cancers in immunosuppressed organ transplant recipients","author":"Penn I","year":"1998","journal-title":"Clin Transpl"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/rr.2000.5269"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2004.00450.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00920207"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002191"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13652"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13528"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13512"},{"key":"e_1_2_8_11_1","unstructured":"SocietyBT UK Guideline on prevention and management of Cytomegalovirus (CMV) infection and disease following solid organ transplantation[Available from:https:\/\/bts.org.uk\/uk\u2010guideline\u2010on\u2010prevention\u2010and\u2010management\u2010of\u2010cytomegalovirus\u2010cmv\u2010infection\u2010and\u2010disease\u2010following\u2010solid\u2010organ\u2010transplantation\/"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-0012.1999.130307.x"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15914"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsb2005114"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12478"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2017030287"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15177"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2010.09.134"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2009.02963.x"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2015.02.002"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.4285\/kjt.22.0036"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/tri.12602"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12110"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000001651"},{"issue":"3","key":"e_1_2_8_25_1","first-page":"S1","article-title":"KDIGO clinical practice guideline for the care of kidney transplant recipients","volume":"9","author":"Kidney Disease: Improving Global Outcomes Transplant Work G","year":"2009","journal-title":"Am J Transplant"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39493.646875.AE"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39504.506319.80"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39490.551019.BE"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a744"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39500.677199.AE"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0195-6701(96)90127-9"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1086\/319366"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.15292","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T07:10:49Z","timestamp":1713769849000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.15292"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,28]]},"references-count":32,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1111\/ctr.15292"],"URL":"https:\/\/doi.org\/10.1111\/ctr.15292","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,28]]},"assertion":[{"value":"2024-01-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e15292"}}