{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T16:47:39Z","timestamp":1784738859700,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T00:00:00Z","timestamp":1725408000000},"content-version":"vor","delay-in-days":3,"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":[[2024,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Evaluate cytomegalovirus (CMV) post\u2010prophylaxis surveillance in high\u2010risk (D+\/R\u2010) kidney and liver transplant recipients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adult D+\/R\u2010 patients were included if transplanted between 6\/1\/15 and 11\/30\/22 and divided into a pre\u2010CMV\u2010stewardship\u2010era (6\/1\/15\u20135\/31\/18), CMV\u2010stewardship\u2010era (6\/1\/18\u20136\/30\/20), and a surveillance\u2010era (7\/1\/2020\u201311\/30\/2022) then followed through 12 months. The primary objective was to evaluate CMV\u2010related outcomes. The secondary objective was to assess graft and patient survival by era.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 328 patients in the study period; 133 in the pre\u2010stewardship\u2010era, 103 in the stewardship\u2010era, and 92 in the surveillance\u2010era.<\/jats:p><jats:p>Replication rates in the surveillance\u2010era were significantly higher, as anticipated due to increased sampling (pre 38.4%, stewardship 33.0%, surveillance 52.2%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.02). Time from transplant to first replication was similar (pre 214.0\u00a0\u00b1\u00a079.0 days, stewardship 231.1\u00a0\u00b1\u00a065.5, surveillance 234.9\u00a0\u00b1\u00a061.4, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.29). CMV viral load (VL) at first detection, maximum\u2010VL, and incidence of VL &gt; 100\u2009000 IU\/mL were numerically lower in the surveillance era, although not statistically significant. CMV end\u2010organ disease (<jats:italic>p<\/jats:italic> &lt; 0.0001) and ganciclovir\u2010resistance (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.002) were significantly lower in the surveillance era than in both previous eras.<\/jats:p><jats:p>Rejection was not different between eras (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.4). Graft (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.0007) and patient survival (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.008) were significantly improved in the surveillance era.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Post\u2010prophylaxis surveillance significantly reduced CMV end\u2010organ disease and resistance. Despite observing increased replication rates in the surveillance era, rejection was not significantly different and there was no graft loss or patient mortality at 12 months.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.15453","type":"journal-article","created":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T08:50:48Z","timestamp":1725439848000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Cytomegalovirus Post\u2010Prophylaxis Surveillance in High\u2010Risk Kidney and Liver Recipients Prevents CMV End\u2010Organ Disease and Ganciclovir\u2010Resistance"],"prefix":"10.1111","volume":"38","author":[{"given":"Margaret R.","family":"Jorgenson","sequence":"first","affiliation":[{"name":"Department of Pharmacy University of Wisconsin Hospital and Clinics  Madison Wisconsin 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and Public Health, University of Wisconsin Hospital and Clinics  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannina A.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Wisconsin\u2010Madison School of Medicine and Public Health, University of Wisconsin Hospital and Clinics  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Rice","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Wisconsin\u2010Madison School of Medicine and Public Health, University of Wisconsin Hospital and Clinics  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier A.","family":"Mandelbrot","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Wisconsin\u2010Madison School of Medicine and Public Health, University of Wisconsin Hospital and Clinics  Madison 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