Quantiferon-CMV Guided Prophylaxis Fails to Lower Infection in Seropositive Kidney Recipients

Cytomegalovirus remains a primary driver of opportunistic morbidity and graft complications following kidney transplantation [1, 2]. While high-risk serodiscordant pairs typically receive universal prophylaxis, the optimal management for seropositive recipients, who comprise up to 95% of the transplant population in some regions, remains a subject of clinical debate [3, 4]. Current strategies often fluctuate between universal prophylaxis, which carries risks of neutropenia and late-onset disease, and preemptive therapy, which requires intensive virological surveillance [5, 6]. Recent efforts have focused on using cell-mediated immunity assays to individualize these protocols by measuring the patient's functional T-cell response against the virus [7, 6]. A new study now evaluates whether this immunoguided approach can successfully transition from high-risk protocols into routine clinical practice for low-risk recipients.