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To inform the optimal care of these patients, under the auspices of the Italian GITMO, SITO, SIMIT, and AMCLI transplant, infectious, and clinical microbiology societies, we updated the guidelines published in 2019. New recommendations were produced using a consensus\u2010building methodology after a comprehensive review of articles released from 2019 to 2025 (March). Five domains and 31 key questions were selected through a series of questionnaires using a Delphi process. The recommendations on CMV management in transplant recipients were related to diagnostics, prevention, and treatment. Key recommendations include: in both allo\u2010HSCT and SOT, donor and recipient should be evaluated for anti\u2010CMV serological status before transplant for risk stratification; monitoring of CMV infection after transplant should be performed by assaying CMV DNAemia with real time PCR; CMV\u2010specific cell mediated immunity should be monitored after transplantation in allo\u2010HSCT and SOT; in CMV seropositive adult allo\u2010HSCT recipients with negative CMV DNAemia, letermovir prophylaxis is recommended; there is no mandatory indication to universal prophylaxis in SOT recipients; preemptive antiviral therapy is recommended in patients with clinically significant CMV infection (CS\u2010CMV\u2010i); in patients with resistant or refractory CMV infection or disease after first\u2010line antiviral therapy, oral maribavir is recommended as second line antiviral therapy. In conclusion, these recommendations aim to guide clinical practice and improve outcomes in this high\u2010risk population.<\/jats:p>","DOI":"10.1111\/ctr.70255","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T08:54:49Z","timestamp":1753433689000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Management of Cytomegalovirus Infection in Allogeneic Hematopoietic Stem Cell and in Solid Organ Transplantation: Updated Recommendations by the GITMO, SITO, SIMIT, and AMCLI Italian Societies"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3245-2357","authenticated-orcid":false,"given":"Corrado","family":"Girmenia","sequence":"first","affiliation":[{"name":"Department of Hematology, Oncology and Dermatology, AOU Policlinico Umberto I Sapienza University of Rome  Roma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Lazzarotto","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences University of Bologna  Bologna Italy"},{"name":"Microbiology Unit IRCCS Azienda Ospedaliero\u2010Universitaria Di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Martino","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplantation and Cellular Rerapies Unit (CTMO), Stem Cell Transplant Program CIC 587, Department of Hemato\u2010Oncology and Radiotherapy Grande Ospedale Metropolitano \u201cBianchi\u2010Melacrino\u2010Morelli\u201d, Presidio Morelli  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Bonifazi","sequence":"additional","affiliation":[{"name":"Hematopoietic Stem Cell Transplant Program IRCSS Azienda Ospedaliero\u2010Universitaria Di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fausto","family":"Baldanti","sequence":"additional","affiliation":[{"name":"Molecular Virology Unit, Department of Microbiology and Virology Fondazione IRCCS Policlinico San Matteo  Pavia Italy"},{"name":"Department of Clinical, Surgical, Diagnostic and Pediatric Sciences University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierangelo","family":"Clerici","sequence":"additional","affiliation":[{"name":"Associazione Microbiologi Clinici Italiani (AMCLI)  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0489-6337","authenticated-orcid":false,"given":"Franco","family":"Citterio","sequence":"additional","affiliation":[{"name":"Department of Surgery Fondazione Policlinico Universitario A. 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