{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T04:32:25Z","timestamp":1791952345322,"version":"4.3.4"},"reference-count":50,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,10,18]],"date-time":"2019-10-18T00:00:00Z","timestamp":1571356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1150351"],"award-info":[{"award-number":["GNT1150351"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cytomegalovirus (CMV) remains a significant contributor to morbidity and mortality following solid organ transplantation (SOT). While recurrent infection occurs in up to 30% of patients, its impact on mortality is unclear. The aim of this study was to explore the relationship between recurrent CMV infection and long\u2010term survival in SOT recipients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective cohort study of SOT recipients who completed treatment for an episode of CMV infection. Patients were followed until death, loss to follow\u2010up or 10\u00a0years following CMV treatment completion. Univariable and multivariable hazard ratios (HR) were calculated, treating relapse and rejection following CMV as time\u2010varying.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>About 79 kidney, 52 heart, 34 liver, and 5 liver\u2010kidney transplant recipients were included. About 62\/170 died, at a median of 3.8\u00a0years (IQR 0.8\u20106.6\u00a0years). Median follow\u2010up among the 108 survivors was 7.4\u00a0years (IQR 3.7\u201010\u00a0years). Recurrent CMV infection occurred in 49\/170 (29%), 67% within 6\u00a0months of treatment completion. Mortality among those who relapsed was 39% (19\/49) vs 36% (43\/121) in those who remained relapse\u2010free (unadjusted HR 1.59, 95% CI 0.92\u20102.75, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.10). After adjusting for age and transplanted organ, findings were similar (HR 1.68, 95% CI 0.93\u20103.04, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.09).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Mortality following CMV remains high even in the valganciclovir era. Although our findings suggest a possible increased risk of death among patients with recurrent CMV, these did not reach statistical significance. The complex nature of these patients, multiple potential confounders, and limited statistical power made detection of small effects difficult. Larger prospective studies evaluating the clinical impact of strategies to reduce recurrence are needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13189","type":"journal-article","created":{"date-parts":[[2019,10,3]],"date-time":"2019-10-03T16:19:11Z","timestamp":1570119551000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["The impact of recurrent cytomegalovirus infection on long\u2010term survival in solid organ transplant recipients"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5609-3937","authenticated-orcid":false,"given":"Bradley J.","family":"Gardiner","sequence":"first","affiliation":[{"name":"Division of Geographic Medicine and Infectious Disease Tufts Medical Center and Tufts University School of Medicine Boston MA USA"},{"name":"Department of Infectious Diseases Alfred Health and Monash University Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer K.","family":"Chow","sequence":"additional","affiliation":[{"name":"Division of Geographic Medicine and Infectious Disease Tufts Medical Center and Tufts University School of Medicine Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel L.","family":"Brilleman","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventative Medicine Monash University Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton Y.","family":"Peleg","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Alfred Health and Monash University Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Snydman","sequence":"additional","affiliation":[{"name":"Division of Geographic Medicine and Infectious Disease Tufts Medical Center and Tufts University School of Medicine Boston MA USA"},{"name":"Tufts Clinical and Translational Science Institute Tufts University Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,10,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1978.03290220058017"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1989.01410120093018"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-198012000-00010"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12103"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002191"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000000641"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nefro.2016.11.018"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/nep.12149"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000000522"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12964"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181aa8d36"},{"issue":"2","key":"e_1_2_9_13_1","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1111\/ajt.15183","article-title":"Cytomegalovirus mismatch still negatively affects patient and graft survival in the era of routine prophylactic and preemptive therapy: a paired kidney analysis","volume":"19","author":"Leeaphorn N","year":"2018","journal-title":"Am J Transplant"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181f7c053"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2011.02.069"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2009.02824.x"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2014.01.001"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000145989.22373.03"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2009.02617.x"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2010.03114.x"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2009.02861.x"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1086\/514555"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2011.01321.x"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12247"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199901150-00016"},{"issue":"3","key":"e_1_2_9_26_1","first-page":"231","article-title":"Prevalence and risk factors of recurrent cytomegalovirus infection in kidney transplant recipients","volume":"8","author":"Nafar M","year":"2014","journal-title":"Iran J Kidney Dis"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix696"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy295"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000001338"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1086\/513949"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1989.03420240075030"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12694"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-126-4-199702150-00003"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz003"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181ff1493"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw084"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2007.01910.x"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1993.01420140042007"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12873"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13051"},{"key":"e_1_2_9_41_1","unstructured":"Genentech.Valcyte (valganciclovir) package insert;2015."},{"key":"e_1_2_9_42_1","unstructured":"Genentech.Cytovene (ganciclovir) package insert;2016."},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw668"},{"issue":"5","key":"e_1_2_9_44_1","first-page":"34","article-title":"Recurrent cytomegalovirus disease in solid\u2010organ transplant recipients","volume":"27","author":"Falagas ME","year":"1995","journal-title":"Transpl Proc"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b5087"},{"key":"e_1_2_9_46_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2018"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2013.03.001"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.23991"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12876"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofy230"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002685"}],"container-title":["Transplant Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftid.13189","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.13189","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tid.13189","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.13189","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T22:24:55Z","timestamp":1694211895000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.13189"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,18]]},"references-count":50,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1111\/tid.13189"],"URL":"https:\/\/doi.org\/10.1111\/tid.13189","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"value":"1398-2273","type":"print"},{"value":"1399-3062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,18]]},"assertion":[{"value":"2019-05-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-09-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-10-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13189"}}