{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T07:40:10Z","timestamp":1784014810100,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"vor","delay-in-days":14,"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":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Cytomegalovirus (CMV) is a common opportunistic infection in solid organ transplant patients. Intravenous CMV immunoglobulin (CMV\u2010IVIG) is a pharmacotherapy option with limited data within heart transplantation. At UCHealth, CMV\u2010IVIG was removed from the heart transplant CMV prophylaxis protocol in July 2022. This study evaluated the efficacy and cost outcomes of CMV\u2010IVIG removal from the protocol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a single\u2010center, retrospective cohort study of heart transplant recipients transplanted at UCHealth between October 2020 and March 2023. Patients were included if seronegative for CMV, and excluded if they died or were lost to follow\u2010up within 12\u00a0months of transplantation. Patients included were compared after being separated into pre\u2010 and post\u2010protocol cohorts if transplanted prior to July 1, 2022 when CMV\u2010IVIG was removed from the protocol and afterward, respectively. Standard universal prophylaxis with valganciclovir was used in both cohorts. The primary outcome was CMV DNAemia within 12\u00a0months of heart transplant, and secondary outcomes included cost avoidance and CMV DNAemia within 18\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010two patients were included in this study. There was no significant difference in CMV DNAemia between pre\u2010 and post\u2010protocol groups at 12\u00a0months (9.5% vs. 4.8%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.55) or 18\u00a0months (28.6% vs. 19%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.53). Median cost avoidance for removing CMV\u2010IVIG from the protocol per patient was $30 652.13\u2013$40 331.75.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Removing CMV\u2010IVIG from a heart transplant protocol was associated with cost avoidance without worsened outcomes in CMV DNAemia. CMV\u2010IVIG likely does not have significant benefits for preventing CMV DNAemia with concomitant universal antiviral prophylaxis in heart transplant recipients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.70147","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T16:33:11Z","timestamp":1744734791000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Twelve\u2010Month Clinical and Cost Outcomes of Removal of Cytomegalovirus Intravenous Immune Globulin From Heart Transplantation Protocol"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8829-8002","authenticated-orcid":false,"given":"Madhumita","family":"Rao","sequence":"first","affiliation":[{"name":"Department of Pharmacy New York University Langone Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"II","given":"Robert L.","family":"Page","sequence":"additional","affiliation":[{"name":"University of Colorado Skaggs School of Pharmacy  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4667-8074","authenticated-orcid":false,"given":"Emily","family":"Sartain","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Colorado Hospital  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000151609.60618.3C"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.23539"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2012.08.1144"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/rmv.2017"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13666"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2019.104211"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002191"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13512"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2010.05.034"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2022.10.015"},{"key":"e_1_2_11_12_1","unstructured":"CytoGam (Cytomegalovirus Immune Globulin Intravenous) [package insert].Roswell GA: Saol Therapeutics Inc.2020."},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890\u2010200111270\u201000012"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/iid3.508"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.97.2.396"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01728886"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.39.7.1643"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1053\u20102498(02)00474\u20106"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2021.01.368"},{"key":"e_1_2_11_20_1","unstructured":"Organ Procurement and Transplantation Network (OPTN) and Scientific Registry of Transplant Recipients (SRTR). OPTN\/SRTR 2022 Annual Data Report. U.S. Department of Health and Human Services Health Resources and Services Administration. Published 2024. Accessed July 19 2024.https:\/\/srtr.transplant.hrsa.gov\/annual_reports\/2022\/Heart.aspx#fig:HRdeceased\u2010rates\u2010adult\u2010waiting\u2010all."},{"key":"e_1_2_11_21_1","unstructured":"Valcyte (Valganciclovir) [package insert].South San Fransisco CA: Genentech Inc.2021."}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70147","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T01:37:13Z","timestamp":1746322633000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.70147"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1111\/ctr.70147"],"URL":"https:\/\/doi.org\/10.1111\/ctr.70147","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2025-01-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70147"}}