{
  "abstract": "Introduction: Cytomegalovirus remains a major challenge in LTx recipients. Despite advances in antiviral therapy, refractory and resistant CMV infections persist, and real-world data on maribavir, a recently approved UL97 kinase inhibitor, are limited.\n\nMethods: We retrospectively analyzed 49 LTx recipients treated with maribavir for refractory and resistant (R/R) CMV between August 2022 and December 2024.\n\nResults: Overall, 34 patients (69.4%) achieved a sustained virological response, defined as complete CMV DNA clearance, with a > 1 log₁₀ viral load decline after a median of 11.5 days and complete viral clearance after a median of 24.8 [7–54] days. Sixteen patients (32.7%) failed therapy; UL97 resistance mutations were detected during maribavir therapy in 14 patients (28.6%). Non-responders had higher baseline viral loads (> 10,000 IU/ml: 53.3% vs. 20.6%; p = 0.047) and slower viral decline (14 (6–85) vs. 10.5 (2–27) days; p = 0.033). In multivariable analysis, higher baseline CMV viral load was independently associated with maribavir resistance (OR 3.729 per log₁₀ increase, 95% CI 1.360–10.226; p = 0.011).\n\nConclusion: In conclusion, maribavir represents an important therapeutic option for R/R CMV after lung transplantation. However, treatment failure, relapse, and resistance remained common, highlighting the need for careful monitoring and further optimization of treatment strategies.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s15010-026-02927-3.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Medicine V, LMU University Hospital, Comprehensive Pneumology Center (CPC-M), LMU Munich, Member of the German Center for Lung Research (DZL), Marchioninistrasse 15, 81377 Munich, Germany",
    "Laboratory for Immunogenetics, University of Munich, LMU, Munich, Germany",
    "Division of Thoracic Surgery, LMU University Hospital, LMU Munich, Member of the German Center for Lung Research (DZL), Munich, Germany",
    "Institute of Lung Health and Immunity (LHI), Comprehensive Pneumology Center (CPC), Helmholtz Munich, Member of the German Center of Lung Research (DZL), Munich, Germany",
    "Department of Cardiac Surgery, LMU University Hospital, LMU Munich, Member of the German Center for Lung Research (DZL), Munich, Germany",
    "Department of Anaesthesiology, University Hospital, LMU, Munich, Germany",
    "Max Von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, LMU, Munich, Germany",
    "Department of Internal Medicine, Division of Respiratory Medicine, Lung Research Cluster, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Tobias Veit",
      "orcid": "0000-0002-4117-0175"
    },
    {
      "affs": [
        0
      ],
      "name": "Stefan Trost"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Teresa Kauke"
    },
    {
      "affs": [
        1
      ],
      "name": "Nina Engels"
    },
    {
      "affs": [
        0
      ],
      "name": "Gabriela Leuschner"
    },
    {
      "affs": [
        0,
        3
      ],
      "name": "Michael Gerckens"
    },
    {
      "affs": [
        0,
        3
      ],
      "name": "Carlo Mümmler"
    },
    {
      "affs": [
        4
      ],
      "name": "Sebastian Michel"
    },
    {
      "affs": [
        5
      ],
      "name": "Michael Zoller"
    },
    {
      "affs": [
        6
      ],
      "name": "Valeria Hackemann"
    },
    {
      "affs": [
        0
      ],
      "name": "Jürgen Behr"
    },
    {
      "affs": [
        7
      ],
      "name": "Nikolaus Kneidinger"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/azqhc1k2rs0s2.bib",
  "cited_by": 0,
  "doi": "10.1007/s15010-026-02927-3",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13727892/",
  "id": "azqhc1k2rs0s2",
  "issns": [
    "0300-8126",
    "1439-0973"
  ],
  "landing_url": "https://doi.org/10.1007/s15010-026-02927-3",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2713|Cytomegalovirus and herpesvirus research"
    ]
  ],
  "openalex": "W7203661280",
  "pdf_url": "https://link.springer.com/content/pdf/10.1007/s15010-026-02927-3.pdf",
  "pmcid": "PMC13727892",
  "pmid": "42611159",
  "published": "2026-08-18",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/azqhc1k2rs0s2.ris",
  "sources": [
    {
      "first_seen": "2026-11-06T12:23:41Z",
      "native_id": "PMC13727892",
      "source": "pmc",
      "url": "https://doi.org/10.1007/s15010-026-02927-3"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Cytomegalovirus and herpesvirus research",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Maribavir in lung transplant recipients with cytomegalovirus infection: real-life experience",
  "title_text": "Maribavir in lung transplant recipients with cytomegalovirus infection: real-life experience",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:21:00Z",
  "url": "https://research.draconitic.com/paper/azqhc1k2rs0s2",
  "venue": "Infection",
  "versions": []
}