{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T12:39:38Z","timestamp":1764679178613,"version":"3.46.0"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,7,13]],"date-time":"2025-07-13T00:00:00Z","timestamp":1752364800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cytomegalovirus (CMV) can cause serious morbidity in transplant patients. Lymphocyte depletion by anti\u2010thymocyte globulin (ATG) may persist for 6\u2009months post\u2010induction, and lower absolute lymphocyte counts (ALC) may increase the risk for CMV. We sought to find the relationship between ALC at induction and CMV viremia in the first 6\u2009months post\u2010transplant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      An analysis of transplant recipients within a set period of time with uniformed induction therapy and CMV prophylaxis. ATG was a primary component of induction and ganciclovir or valganciclovir as prevention of CMV infection. The cohort was dichotomized into low ALC (\u2264\u20090.3\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      cells\/L) and high ALC (&gt;\u20090.3\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      cells\/L) based on lowest ALC during the first 14\u2009days and their clinical characteristics analyzed. CMV viremia was defined as PCR value of &gt;\u2009137\u2009IU\/mL regardless of symptoms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 44 patients were included in this study. CMV viremia occurred in 18% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098). Patients were more likely to develop CMV if post\u2010induction ALC was\n                      <jats:bold>\u2264<\/jats:bold>\n                      \u20090.3\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      cells\/L (28% vs. 0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029) and remained significant when adjusted for CMV serostatus (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). The total ATG dose (7.5 vs. 4.5\u2009mg\/kg) was not predictive of CMV (37% vs. 17%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.3) nor was treatment for rejection (25% vs. 14%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.5. Rejection occurred in 7% compared to 20% of patients in the low vs. high ALC group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.4).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      In pediatric heart transplant recipients, there is a higher incidence of CMV if ALC \u2264\u20090.3\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      cells\/L during induction, regardless of serostatus. Low ALC levels during induction may identify a high\u2010risk group that could benefit from an altered CMV prophylactic regimen.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70136","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T04:08:07Z","timestamp":1752466087000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Low Absolute Lymphocyte Count Associated With Anti\u2010Thymocyte Globulin Induction May Be a Predictor of Early Cytomegalovirus Infection in Pediatric Heart Transplantation"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8167-0043","authenticated-orcid":false,"given":"Allyson","family":"Chan","sequence":"first","affiliation":[{"name":"Loma Linda University Children's Hospital  Loma Linda California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Tan","sequence":"additional","affiliation":[{"name":"Loma Linda University Children's Hospital  Loma Linda California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9692-9432","authenticated-orcid":false,"given":"Sofia","family":"Tan","sequence":"additional","affiliation":[{"name":"Loma Linda University Children's Hospital  Loma Linda California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Micheal","family":"Kuhn","sequence":"additional","affiliation":[{"name":"Loma Linda University Children's Hospital  Loma Linda California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7559-1296","authenticated-orcid":false,"given":"Natalie","family":"Shwaish","sequence":"additional","affiliation":[{"name":"Loma Linda University Children's Hospital  Loma Linda California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9814-1762","authenticated-orcid":false,"given":"Richard","family":"Chinnock","sequence":"additional","affiliation":[{"name":"Loma Linda University Children's Hospital  Loma Linda California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2123-0134","authenticated-orcid":false,"given":"Huyentran","family":"Tran","sequence":"additional","affiliation":[{"name":"Loma Linda University Children's Hospital  Loma Linda California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6607-916X","authenticated-orcid":false,"given":"Erik","family":"Frandsen","sequence":"additional","affiliation":[{"name":"Loma Linda University Children's Hospital  Loma Linda California 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