*Purpose: This study aimed to describe the incidence of cytomegalovirus (CMV) recurrence in heart and lung transplant recipients and the effect of secondary prophylaxis (SP) on this recurrence.

*Methods: This single-center retrospective study examined heart and lung transplant recipients from 1/2018 – 10/2020 who received treatment for CMV viremia. Patients with ganciclovir-resistant CMV were excluded. CMV recurrence-free survival and the effect of SP on CMV recurrence were evaluated using Kaplan-Meier methods. Cox proportional hazards regression evaluated the effect of SP duration on CMV recurrence.

*Results: The sample included 43 adult transplant recipients (24 heart and 19 lung) who were treated for initial CMV viremia (Table 1). Follow-up time after transplant averaged 22.7 ± 6.9 months. The CMV recurrence-free survival estimate was 75.7% at 6 months after completion of the initial CMV treatment (Figure 1). There were 10 recurrences during this 6-month time frame, with an additional 2 occurring in post-treatment months 14 and 15. Nine patients (20.9%) received no SP. Among the 34 patients (79.1%) who received SP, its duration, in weeks, was not related to recurrence-free survival (p=0.204). Whether or not persons received SP was also not related to recurrence-free survival (Figure 2, p=0.202).

*Conclusions: In this sample of heart and lung transplant recipients, SP was not related to CMV recurrence-free survival. A prospective, randomized trial is indicated to determine the utility of SP in the prevention of CMV recurrence.

« Back to 2022 American Transplant Congress