Prophylaxis Durations and Risks of Cytomegalovirus Infection and Disease in Solid Organ Transplant Recipients: An International, Multicenter Cohort Study.

Authors

Anja Lindis Dahl, Oriol Manuel, Michael Koller, Joanne Reekie, Erich Tusch, Kasper Moestrup, Michael Perch, Kasper Rossing, Nicolai Schultz, Soren Schwartz Sorensen, Kristian Schønning, Jens Lundgren, Nicolas Johannes Mueller, Marie Helleberg

Published in

Transplant infectious disease : an official journal of the Transplantation Society. Pages e70321. Oct 09, 2026. Epub Oct 09, 2026.

Abstract

The optimal duration of cytomegalovirus (CMV) prophylaxis in solid organ transplant recipients (SOTr) remains undetermined. We evaluated real-life preventive strategies on the incidence of CMV disease in an international SOTr cohort.
All CMV IgG donor (D)+/recipient (R)- or R+ SOTr in Zürich, Lausanne, and Copenhagen (2008-2022) were followed 12-month post-transplantation. Multivariable Poisson regression examined associations between antiviral prophylaxis duration and risk of CMV infection and CMV disease at time of infection diagnosis.
We included 3203 non-lung (2057 kidney, 815 liver, 331 heart) and 620 lung transplant recipients. Strategies for CMV prophylaxis durations varied from none to ≥ 12 months. For D+/R- non-lung SOTr, no prophylaxis with preemptive therapy only versus 3 months of prophylaxis was associated with higher risk of CMV infection and disease (adjusted incidence rate ratio [aIRR] [95% CI] 2.46 [1.69-3.57], and 2.82 [1.18-6.68]). Risk did not differ between 3 and 6 months of prophylaxis. For D+/R- lung transplant recipients, 3 versus 6 months of prophylaxis was associated with higher risk of CMV infection and high CMV DNAemia (2.74 [1.36-5.52] and 8.10 [1.89-41.90]), but not significantly higher risk of CMV disease. Irrespective of antiviral prophylaxis duration, incidence of CMV disease was lower among R+ compared to D+/R- SOTr.
In a setting with CMV surveillance after prophylaxis, 3 months of antiviral prophylaxis seems adequate to prevent CMV disease in D+/R- non-lung SOTr, whereas lung transplant recipients may benefit from longer duration of prophylaxis. Risk of CMV disease was low among R+ SOTr, irrespective of antiviral prophylaxis.

PMID:
42855943
Bibliographic data and abstract were imported from PubMed on 10 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.