{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T09:18:29Z","timestamp":1793438309618,"version":"4.5.0"},"reference-count":32,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Lung transplant (LT) recipients with high\u2010risk cytomegalovirus (CMV) mismatch donors (donor seropositive, recipient seronegative) have worse early and late outcomes. We sought to describe the outcomes among high\u2010risk mismatch patients managed using proactive monitoring and multimodality prophylaxis and management protocol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included patients with single or bilateral lung transplants between January 2012 and December 2016 (<jats:italic>n<\/jats:italic>\u00a0=\u00a0324). The patients were classified into two groups: high\u2010risk CMV mismatch (R\u2212\/D+): <jats:italic>n<\/jats:italic>\u00a0=\u00a083 (25.6%) and non\u2010high\u2010risk CMV mismatch (<jats:italic>n<\/jats:italic>\u00a0=\u00a0241). Post\u2010LT follow\u2010up period ranged from 8 to 12 years. Post\u2010transplant survival was analyzed as the primary outcome variable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no difference in LT recipients' baseline and post\u2010transplant characteristics with and without CMV\u2010mismatch donors. The mismatch group experienced a significantly higher frequency and burden of CMV viremia (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) and resistant viremia (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). Regardless, the two groups had similar long\u2010term outcomes with no statistically significant difference in CLAD\u2010free survival at 3 years or overall post\u2010transplant survival. On Cox proportional hazard analysis, transplant indication was the only independent predictor of post\u2010transplant survival (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A proactive multimodality CMV management protocol consisting of antiviral agents (ganciclovir\/valganciclovir) and immune augmentation with CMV immune globulin may improve outcomes among high\u2010risk CMV mismatch LT recipients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.70219","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T04:08:46Z","timestamp":1751256526000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Long\u2010Term Outcomes Among Lung Transplant Recipients With High\u2010Risk Cytomegalovirus Mismatch Managed With a Multimodality Regimen"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9399-6884","authenticated-orcid":false,"given":"Natasha","family":"Banga","sequence":"first","affiliation":[{"name":"Lung Transplant Program UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan","family":"Kanade","sequence":"additional","affiliation":[{"name":"Lung Transplant Program UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anishka","family":"Kappalayil","sequence":"additional","affiliation":[{"name":"Lung Transplant Program UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Timofte","sequence":"additional","affiliation":[{"name":"Lung Transplant Program UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Lawrence","sequence":"additional","affiliation":[{"name":"Lung Transplant Program UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivas","family":"Bollineni","sequence":"additional","affiliation":[{"name":"Lung Transplant Program UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaidehi","family":"Kaza","sequence":"additional","affiliation":[{"name":"Lung Transplant Program UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Torres","sequence":"additional","affiliation":[{"name":"Lung Transplant Program UT Southwestern Medical Center  Dallas Texas 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