{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T01:58:20Z","timestamp":1792979900985,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"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":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cytomegalovirus (CMV) viremia is one of the most common opportunistic infections following solid organ transplant (SOT) in pediatric patients and can be associated with significant morbidity. Valganciclovir is the preferred antiviral medication used for CMV prophylaxis in high\u2010risk kidney transplant recipients, but its use is limited by myelosuppression. Letermovir is an alternative antiviral medication with lower rates of neutropenia. Letermovir has been implicated in many potential drug\u2013drug interactions, including in combination with tacrolimus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This report describes the case of a 6\u2010year\u2010old girl, 2\u2009months post\u2010kidney transplant, at risk for CMV, who received letermovir for CMV prophylaxis after developing neutropenia while receiving valganciclovir. Her maintenance immunosuppression included tacrolimus. This report describes the drug\u2013drug interaction of letermovir and tacrolimus, the dose adjustments required, and summarizes the available literature on the interaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>While on concurrent letermovir and tacrolimus, the patient required a 36% tacrolimus dose reduction and additional therapeutic drug level monitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case adds to the current limited data on the interaction of letermovir and tacrolimus in the pediatric SOT population.<\/jats:p>\n                  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