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However, recent trends in clinical practice call for a reevaluation of cytomegalovirus infection risks after solid organ transplantation. Indeed, whereas early\u2010onset cytomegalovirus infection is usually controlled by antiviral prophylaxis with ganciclovir and derivatives, delayed\u2010and late\u2010onset cytomegalovirus infection can develop after the completion of a course of preventive therapy. In addition, indirect effects of cytomegalovirus infection may occur as a result of persistent low\u2010level viremia. Suboptimal dosing of antiviral drugs due to specific drug toxicities may result in the development of ganciclovir\u2010resistant cytomegalovirus disease. The relationship between organ allograft rejection and cytomegalovirus infection and disease has been recognized for some time. Transplantation of increasing numbers of extended\u2010criteria donor organs increases the risk of delayed graft function and acute rejection, prompting the use of more intensive immunosuppression. In addition, the trend to spare long\u2010term exposure to calcineurin inhibitors has contributed to a resurgence in the use of polyclonal T\u2010cell induction immunosuppressive agents, which may reduce host anticytomegalovirus immunity. We discuss the current trends in solid organ transplantation that provide a foundation for defining risks for cytomegalovirus infection and disease, including identification of patients who would benefit from more aggressive cytomegalovirus monitoring and prevention strategies.<\/jats:p>","DOI":"10.1592\/phco.30.2.144","type":"journal-article","created":{"date-parts":[[2010,1,26]],"date-time":"2010-01-26T07:58:26Z","timestamp":1264492706000},"page":"144-157","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Defining the Risks for Cytomegalovirus Infection and Disease After Solid Organ Transplantation"],"prefix":"10.1002","volume":"30","author":[{"given":"Robert J.","family":"Stratta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolynn","family":"Pietrangeli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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