*Purpose: Little is known about the effect of CMV infection on transplant messenger RNA expression utilizing the molecular microscope (MMDx) in the absence of acute rejection in heart transplant patients.

*Methods: Data from 9 samples collected from 7 heart transplant recipients at our single institution were analyzed. Patients with at least one MMDX post-transplant with known CMV serology were documented.

*Results: A total of 7 heart transplant recipients were included in the study (mean age 61.4 ±4.8 years, all male, with variable CMV status. (4 CMV D+/R+, 2 CMV D+/R-, 1 CMV D-/R+). All patients were reported to have active or recent (within 6 months of MMDx) CMV infection or asymptomatic viremia at the time of MMDx analysis. MMDx analysis revealed that none of the samples had diagnosis of t-cell mediated rejection or antibody mediated rejection. Of the 9 total samples, a majority (5/9) had an abnormal response in the interferon-gamma related transcript, GRIT. None of the patients had an abnormal detection in levels of EDSAST, ROBO4, CXCL13, CTLA4 gene sets. All MMDx testing results are shown. (Table) There were no reported deaths in the one-year follow-up.

*Conclusions: CMV infection in heart transplant recipients is associated with an increase in non-specific mRNA expression as demonstrated by the MMDx. Further studies are needed to validate these preliminary findings.

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