{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T10:12:18Z","timestamp":1789207938875,"version":"build-2803163510"},"reference-count":87,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      The 2025 International CMV Symposium convened in K\u00f6nigstein, Germany, bringing together transplant clinicians and researchers to address cytomegalovirus management following the publication of three major guidelines in 2025. The Transplantation Society, European Conference on Infections in Leukaemia, and American Society for Transplantation and Cellular Therapy each released updated recommendations reflecting significant advances, including letermovir prophylaxis for hematopoietic stem cell and high\u2010risk renal transplantation, maribavir for resistant or refractory disease, and cell\u2010mediated immunity testing to guide personalized prevention strategies. This review synthesizes symposium discussions, emphasizing translation of evidence\u2010based recommendations into clinical practice across diverse healthcare settings. Key topics included risk\u2010stratified prevention approaches balancing efficacy with practical implementation, precision medicine through immune biomarkers, adoptive cellular therapies advancing from experimental to clinical platforms, and vaccine development showing renewed promise after decades of setbacks. Symposium faculty highlighted persistent challenges despite recent progress, such as late\u2010onset disease after extended prophylaxis, economic barriers limiting access to novel therapies and diagnostics, resistance patterns evolving with increasing antiviral use, and infrastructure requirements for preemptive strategies that may be prohibitive in many settings. Case presentations illustrated real\u2010world practical challenges to effective guideline implementation. The integration of solid organ and hematopoietic stem cell transplant expertise enabled cross\u2010disciplinary learning while respecting population\u2010specific differences. As the transplant community advances toward defeating the \u201ctroll of transplantation,\u201d continued therapeutic innovation must be coupled with implementation science, economic analyses, and global cooperation to ensure all transplant recipients benefit from these advances.\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid70223-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  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