*Purpose: To describe Pneumocystis Jirovecii Pneumonia (PJP) prophylaxis (ppx) practices in our transplant recipients and to determine its safety and efficacy.

*Methods: Retrospective review of kidney and liver transplant recipients transplanted between 5/9/15 and 11/30/17 to describe PJP ppx; medications, safety and efficacy. Patients were followed for the course of their ppx; 3 months for liver alone and 6 months for kidney and liver-kidney transplants. Patients who died or had graft loss prior to the ppx cut-off were excluded. Logistic regression was used to identify predictors associated with infection post-transplant. Infection was defined as positive culture with treatment.

*Results: 127 transplant recipients were included in this study period. Patient demographics can be seen in Table 1. The percent of patients who received TMP/SMX ppx differed between transplant types (p<0.01.) Table 2 contains reasons why alternative agents were commonly used. In univariate logistic regression analysis, TMP/SMX ppx was associated with a statistically significant reduction in odds of any infection among kidney and liver-kidney transplants (OR=0.23 (0.07-0.67), p<0.01). There was a trend towards reduced odds of any infection among solitary liver transplants, though not statistically significant (OR=0.29 (0.04-1.37), p=0.15). No episodes of PJP occurred.

*Conclusions: TMP/SMX, Dapsone and Pentamidine used for PJP ppx in our patient population were safe and efficacious. However, TMP/SMX ppx reduced likelihood of any infection among kidney and liver-kidney transplants. Continued monitoring of PJP ppx and outcomes in this population is warranted.

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