{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T01:58:18Z","timestamp":1792979898353,"version":"4.5.0"},"reference-count":48,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":17,"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>Cytomegalovirus (CMV) is associated with morbidity and mortality after a kidney transplant (KT). Letermovir (LTV) was approved in high\u2010risk KT recipients, providing an alternative to standard\u2010of\u2010care valganciclovir (VGC) associated with reduced myelosuppression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adult patients receiving a kidney transplant with moderate\u2010risk CMV serostatus between 1\/1\/2021 and 6\/6\/2024 were evaluated. Patients were included in VGC or LTV cohort based on de novo prophylaxis regimen. The primary outcomes were efficacy and tolerability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Four hundred and eight KTRs met inclusion criteria: 316 received VGC, 92 received LTV. Cohorts were comparable; the majority received a primary (84.2%\u00a0vs. 90.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.566) deceased donor (69.6%\u00a0vs. 68.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.298) transplant with lymphocyte depleting induction (82.3%\u00a0vs. 90.2%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.32). Significantly more patients in the VGC cohort required antiviral dose adjustment (61.7%\u00a0vs. 1.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.0001). Patients in the LTV cohort were significantly more likely to complete antiviral prophylaxis (63.3%\u00a0vs. 84.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.0001). Patients in the VGC cohort were significantly more likely to experience leukopenia (65.8%\u00a0vs. 45.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0006) and neutropenia (30.7%\u00a0vs. 12.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0002) during the first\u2010year post\u2010KT. Significantly more patients in the LTV cohort were on the equivalent of &gt;1000\u00a0mg mycophenolate\/day at 12 months post\u2010KT (59.9%\u00a0vs. 74.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0173). Rates of CMV viremia and clinically significant disease through 1\u2010year post\u2010KT were comparable.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>De novo LTV in R+ KTRs appears to be safe and effective compared to VGC. This study suggests antiviral prophylaxis is more likely to be successfully completed with LTV and requires less dose titration. Additionally, LTV appears to be associated with less myelosuppression, permitting higher mycophenolate doses at 12 months and avoiding corrective healthcare resource utilization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70423","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T08:41:19Z","timestamp":1766047279000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["De Novo Letermovir After Cytomegalovirus Seropositive Kidney Transplant Improves Toxicity and Mycophenolate Tolerance Over the Current Standard of Care"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3149-6558","authenticated-orcid":false,"given":"Hanna L.","family":"Kleiboeker","sequence":"first","affiliation":[{"name":"Department of Pharmacy University of Wisconsin Hospital and Clinics  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6088-9727","authenticated-orcid":false,"given":"Margaret R.","family":"Jorgenson","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Wisconsin Hospital and Clinics  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Scolarici","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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1196-5110","authenticated-orcid":false,"given":"Jillian L.","family":"Descourouez","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Wisconsin Hospital and Clinics  Madison Wisconsin 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