{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T11:31:48Z","timestamp":1770291108073,"version":"3.49.0"},"reference-count":13,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T00:00:00Z","timestamp":1675382400000},"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":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite superiority of preemptive therapy (PET) compared to universal prophylaxis for prevention of cytomegalovirus (CMV) disease in the CAPSIL randomized trial among CMV D+R\u2010 liver transplant recipients (LTxRs), real\u2010world effectiveness may be lower because of logistical concerns about feasibility of PET.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively assessed PET as standard clinical care at a single transplant center among 50 consecutive adult CMV D+R\u2010 LTxRs undergoing a first liver transplant between 4\/4\/2019 and 5\/18\/2021 and compared outcomes and adherence to those randomized to PET in the CAPSIL study (<jats:italic>N<\/jats:italic> = 100). The primary outcome was CMV disease and secondary outcomes were biopsy\u2010confirmed acute allograft rejection, retransplant, invasive fungal infections, and death, all assessed by 1\u2010year post\u2010transplant. Exploratory outcomes included virologic parameters and measures of adherence to protocol\u2010specified CMV qPCR monitoring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline characteristics were similar between groups. The cumulative incidence of CMV disease at 1\u2010year post\u2010transplant was 4\/50 (8%) versus 9\/100 (9%) in the real\u2010world and CAPSIL cohorts, respectively, p = 1.0. The rate of breakthrough CMV disease during the 100\u2010day PET period was low (2\/50 [4%]) and similar to the PET cohort from the CAPSIL study (3\/100 [3%]).\u00a0\u00a0All secondary and exploratory outcomes were not significantly different between the real\u2010world and CAPSIL PET cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this first reported study of real\u2010world PET, the feasibility and effectiveness for CMV disease prevention and for other clinical outcomes in CMV D+R\u2010 LTxRs were similar to those reported with PET in a clinical trial. Additional studies to confirm feasibility and generalizability in other settings are warranted.\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid14015-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.14015","type":"journal-article","created":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T13:45:30Z","timestamp":1675431930000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Real\u2010world effectiveness of preemptive therapy (PET) for cytomegalovirus (CMV) disease prevention in CMV high\u2010risk donor seropositive\/recipient seronegative (D+R\u2010) liver transplant recipients (LTxR)"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6481-5861","authenticated-orcid":false,"given":"Kathleen M.","family":"Doss","sequence":"first","affiliation":[{"name":"Division of Allergy and Infectious Diseases Department of Medicine University\u00a0of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine E.","family":"Kling","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery Department of Surgery University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madeleine R.","family":"Heldman","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine Duke University  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Singh","sequence":"additional","affiliation":[{"name":"University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marilyn","family":"Wagener","sequence":"additional","affiliation":[{"name":"University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert M.","family":"Rakita","sequence":"additional","affiliation":[{"name":"Division of Allergy and Infectious Diseases Department of Medicine University\u00a0of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia E.","family":"Fisher","sequence":"additional","affiliation":[{"name":"Division of Allergy and Infectious Diseases Department of Medicine University\u00a0of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajit P.","family":"Limaye","sequence":"additional","affiliation":[{"name":"Division of Allergy and Infectious Diseases Department of Medicine University\u00a0of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,2,3]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.4849"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12006"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.3138"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002191"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13512"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiz454"},{"key":"e_1_2_11_8_1","article-title":"Definitions of CMV infection and disease in transplant patients for use in clinical trials","author":"Ljungman P","year":"2016","journal-title":"Clin Infect 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Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.14015","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tid.14015","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.14015","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T21:17:15Z","timestamp":1692652635000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.14015"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,3]]},"references-count":13,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["10.1111\/tid.14015"],"URL":"https:\/\/doi.org\/10.1111\/tid.14015","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"value":"1398-2273","type":"print"},{"value":"1399-3062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,3]]},"assertion":[{"value":"2022-10-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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