Evolving trends in immunosuppression use and cytomegalovirus infection risk over the past decade in kidney transplantation.

Increasing use of potent immunosuppression coupled with higher CMV D+/R- F rates may be driving higher rates of CMV infection. Cyclosporine and mTORi conversion appears to be protective against CMV.  A more individualized immunosuppression regimen based on infection risk merits consideration.