{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T20:04:47Z","timestamp":1773000287294,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Due to the hematologic toxicities associated with standard\u2010dose valganciclovir (VGCV), low\u2010dose (LD) VGCV has been proposed as an alternative, primarily in abdominal transplant recipients. Data on LD VGCV outcomes in heart transplant recipients (HTR) remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single\u2010center, retrospective, stimulating cohort study describes adult, cytomegalovirus (CMV) D+\/R\u2212 and R+ HTR transplanted between January 1, 2013 and September 30, 2022 and maintained on, at most, VGCV 450\u00a0mg daily for primary CMV prophylaxis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 338 HTR were reviewed, of whom 80 CMV D+\/R\u2212 and 154 R+ HTR met criteria for inclusion. Of the 234 HTR, the median age was 56 years, the mean body mass index (BMI) was 26.9\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , and 93 (39.7%) had an estimated glomerular filtration rate \u226560\u00a0mL\/min\/1.72\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      at post\u2010transplant month 12. Breakthrough (BT) CMV occurred in six (2.6%) individuals, exclusively among CMV D+\/R\u2212 HTR. Two cases were complicated by CMV end\u2010organ disease (retinitis, colitis) with ganciclovir (GCV) resistance. Leukopenia occurred in 67.1% of the total cohort, necessitating frequent VGCV and mycophenolate adjustments.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This is the largest report of LD VGCV use in HTR. Despite reduced VGCV exposure, HTR remain at high risk for cytopenias. Regardless of potential risk factors, including a high prevalence of overweight BMI and adequate renal function, LD VGCV was associated with expected rates of BT CMV and CMV resistance, suggesting LD VGCV could be considered in HTR. Identification of CMV end\u2010organ disease and GCV resistance suggests that LD VGCV could be considered cautiously in CMV D+\/R\u2212 HTR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70408","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T14:33:21Z","timestamp":1765377201000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Low\u2010Dose Valganciclovir for Primary Cytomegalovirus Prophylaxis After Heart Transplant: A 10\u2010Year Experience"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2803-9704","authenticated-orcid":false,"given":"Kennedy","family":"Concannon","sequence":"first","affiliation":[{"name":"Department of Pharmacy University of Colorado Hospital  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2390-2392","authenticated-orcid":false,"given":"Robert","family":"Page","sequence":"additional","affiliation":[{"name":"University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4739-3484","authenticated-orcid":false,"given":"Rebecca","family":"Swayngim","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Colorado Hospital  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3503-4203","authenticated-orcid":false,"given":"Amrut V.","family":"Ambardekar","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Cardiology University of Colorado  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5241-3435","authenticated-orcid":false,"given":"Chia\u2010Yu","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases University of Colorado  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7058-6831","authenticated-orcid":false,"given":"Kelly","family":"Schoeppler","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Colorado Hospital  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"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":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890\u2010200010270\u201000007"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2014.01.001"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000005374"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20106143.2004.00382.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20106143.2010.03074.x"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13512"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhlto.2023.100047"},{"key":"e_1_2_10_9_1","unstructured":"Valcyte (valganciclovir) [package insert]. 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