{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:27:24Z","timestamp":1790083644939,"version":"4.0.1"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,6,30]],"date-time":"2024-06-30T00:00:00Z","timestamp":1719705600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,6,30]],"date-time":"2024-06-30T00:00:00Z","timestamp":1719705600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100004334","name":"Merck","doi-asserted-by":"publisher","award":["61223"],"award-info":[{"award-number":["61223"]}],"id":[{"id":"10.13039\/100004334","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":[[2024,10]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n The goal was to determine trends in immunosuppression use and its impact on cytomegalovirus (CMV) outcomes over the past 10 years.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This was a single\u2010center longitudinal cohort study of adult kidney recipients transplanted between Jan 2012 and June 2021. Baseline and follow\u2010up data were gathered via chart abstraction and analyzed using univariate and multivariate analyses.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 2392 kidney transplants conducted, 131 patients did not meet inclusion criteria. The mean age was 52 years, 41% were female, 57% were black, and 19% were CMV high\u2010risk. The use of rabbit anti\u2010thymocyte globulin (RATG) induction (odds ratio [OR] 1.6, 1.3\u20132.1), tacrolimus (FK) level >8\u00a0ng\/mL (OR 1.1, 1.09\u20131.11), CMV D+\/R\u2010 rates (OR 1.06, 1.02\u20131.10), white blood cell count <3000 (OR 1.22, 1.18\u20131.26) and valganciclovir prophylaxis (OR 1.7, 1.6\u20131.9) have significantly increased over the past 10 years.\u00a0 Rejection rates (OR 0.86, 0.82\u20130.91) and BK viremia >2000 (OR 0.91, 0.91\u20130.98) have decreased. RATG induction (adjusted hazard ratio [aHR] 1.35, 1.2\u20131.5), FK >8\u00a0ng\/mL (aHR 3.5, 3.2\u20133.9), Belatacept conversion (aHR 2.5, 2.1\u20133.1), and rejection (aHR 1.8, 1.6\u20132.0) were significant risk factors for developing CMV infection, while mycophenolate mofetil <1500\u00a0mg (aHR 0.52, 0.47\u20130.59), mammalian target of rapamycin inhibitor (mTORi) conversion (0.77, 0.56\u20130.89), cyclosporine\u2010A conversion (aHR 0.68, 0.56\u20130.84) were associated with lower risk of CMV infection.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Increasing use of potent immunosuppression coupled with higher CMV D+\/R\u2010 F rates may be driving higher rates of CMV infection. Cyclosporine and mTORi conversion appears to be protective against CMV.\u00a0 A more individualized immunosuppression regimen based on infection risk merits consideration.\n \n \n image<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/tid.14318","type":"journal-article","created":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T02:30:17Z","timestamp":1719801017000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Evolving trends in immunosuppression use and cytomegalovirus infection risk over the past decade in kidney transplantation"],"prefix":"10.1111","volume":"26","author":[{"given":"Karim","family":"Soliman","sequence":"first","affiliation":[{"name":"Medical Services Ralph H. Johnson VA Medical Center Charleston South Carolina USA"},{"name":"Department of Medicine Division of Nephrology Medical University of South Carolina Charleston South Carolina USA"},{"name":"Department of Surgery Division of Transplant Surgery Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8751-6468","authenticated-orcid":false,"given":"Isabel K.","family":"Calimlim","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Transplant Surgery Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3808-4751","authenticated-orcid":false,"given":"Amy","family":"Perry","sequence":"additional","affiliation":[{"name":"Medical Services Ralph H. Johnson VA Medical Center Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Andrade","sequence":"additional","affiliation":[{"name":"College of Medicine Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"Overstreet","sequence":"additional","affiliation":[{"name":"Department of Surgery Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neha","family":"Patel","sequence":"additional","affiliation":[{"name":"Pharmacy Services Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicia","family":"Bartlett","sequence":"additional","affiliation":[{"name":"Pharmacy Services Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7273-4589","authenticated-orcid":false,"given":"David J.","family":"Taber","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Transplant Surgery Medical University of South Carolina Charleston South Carolina USA"},{"name":"Department of Surgery Medical University of South Carolina Charleston South Carolina USA"},{"name":"Pharmacy Services Ralph H. Johnson VA Medical Center Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,30]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.25122\/jml\u20102021\u20100209"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2481"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1189"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw668"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy696"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2019.01.041"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2019.04.020"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.4103\/1319\u20102442.261333"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13265"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13689"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16132"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13983"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16430"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.12659\/AOT.915885"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/1178122X19840371"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms11020458"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1590\/2175\u20108239\u2010JBN\u20102022\u20100042en"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1941"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfx281"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2023.02.004"}],"container-title":["Transplant Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.14318","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tid.14318","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.14318","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T07:29:20Z","timestamp":1773646160000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.14318"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,30]]},"references-count":20,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1111\/tid.14318"],"URL":"https:\/\/doi.org\/10.1111\/tid.14318","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"value":"1398-2273","type":"print"},{"value":"1399-3062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,30]]},"assertion":[{"value":"2024-04-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14318"}}