{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:44:15Z","timestamp":1753879455819,"version":"3.41.2"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,8,14]],"date-time":"2021-08-14T00:00:00Z","timestamp":1628899200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Viral infections are controlled primarily by viral\u2010specific T cells, raising concern for adequate T\u2010cell response to clear CMV infection in transplant recipients receiving lymphocyte\u2010depleting agents (LDA). We examined the rates of CMV viremia and clearance, seroconversion, and CMV\u2010specific CD8+ T cell (CMV\u2010Tc) activity with class of induction agent received.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review of 45 pediatric renal transplant recipients who received induction with LDA (<jats:italic>n<\/jats:italic>\u00a0=\u00a031) or non\u2010LDA (NLDA; <jats:italic>n<\/jats:italic>\u00a0=\u00a014) received valganciclovir prophylaxis for 6\u00a0months post\u2010transplant and CMV\u2010PCR monitoring. CMV\u2010Tc was measured by intracellular IFN\u03b3 flow cytometry, when possible, at baseline, 1\u00a0month after CMV viremia (&gt;5 copies\/PCR) and serially until CMV\u2010Tc was positive (\u22650.2%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Viremia rates at 1, 2, and 4\u00a0years post\u2010transplant were higher in LDA vs. NLDA (46.3% vs. 7.2%, 64.2% vs. 7.2%, and 64.2% vs. 7.2%, respectively; <jats:italic>p\u00a0<\/jats:italic>=\u00a0.002). Viremia rates at these time points in seronegative LDA (50.3%, 71.6%, 71.6%) were significantly or near significantly higher than seronegative NLDA (9.1%, 9.1%, 9.1%; <jats:italic>p\u00a0<\/jats:italic>=\u00a0.004), seropositive\u2010LDA (22.3%, 22.3%, 22.3%; <jats:italic>p\u00a0<\/jats:italic>=\u00a0.07), or seropositive NLDA (0%, 0%, 0%; <jats:italic>p\u00a0<\/jats:italic>=\u00a0.07). Eleven of 17 (64.7%) viremic subjects required valganciclovir dose reduction during the prophylaxis period for leukopenia. All viremic LDA patients developed CMV\u2010Tc. One viremic NLDA patient did not develop CMV\u2010Tc. No patients developed CMV disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CMV seronegative pediatric renal transplant patients receiving LDA are more likely to have valganciclovir prophylaxis dose reduction and develop subclinical CMV viremia; however, all developed CMV\u2010Tc. Larger prospective studies are needed to further understand the effects of induction agents on CMV\u2010Tc and CMV\u2010Tc's role post\u2010transplant.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14119","type":"journal-article","created":{"date-parts":[[2021,8,14]],"date-time":"2021-08-14T08:01:07Z","timestamp":1628928067000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Development of CMV\u2010specific cytotoxic T cells (CMV\u2010Tc) in pediatric renal transplant recipients with CMV viremia"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2997-7483","authenticated-orcid":false,"given":"Helen","family":"Pizzo","sequence":"first","affiliation":[{"name":"Pediatric Nephrology Cedars\u2010Sinai Medical Center Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bongha","family":"Shin","sequence":"additional","affiliation":[{"name":"Transplant Immunology Laboratory and Comprehensive Transplant Center Cedars\u2010Sinai Medical Center Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jon","family":"Garrison","sequence":"additional","affiliation":[{"name":"Transplant Immunology Laboratory and Comprehensive Transplant Center Cedars\u2010Sinai Medical Center Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edmund","family":"Huang","sequence":"additional","affiliation":[{"name":"Transplant Immunology Laboratory and Comprehensive Transplant Center Cedars\u2010Sinai Medical Center Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Malekzadeh","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology University of California Los Angeles Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stanley C.","family":"Jordan","sequence":"additional","affiliation":[{"name":"Transplant Immunology Laboratory and Comprehensive Transplant Center Cedars\u2010Sinai Medical Center Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6988-8533","authenticated-orcid":false,"given":"Dechu","family":"Puliyanda","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology Cedars\u2010Sinai Medical Center Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mieko","family":"Toyoda","sequence":"additional","affiliation":[{"name":"Transplant Immunology Laboratory and Comprehensive Transplant Center Cedars\u2010Sinai Medical Center Los Angeles CA 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