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Despite widespread use of prevention strategies, CMV DNAemia remains common in PLTR. Contemporary data, however, is limited. We sought to determine the frequency of, risk factors for, and long term outcomes of CMV DNAemia in a large, single center cohort of PLTR.

A retrospective cohort study of PLTR < 22 yrs of age transplanted from 2011-2018 was completed. Per protocol, CMV prophylaxis with ganciclovir/valganciclovir was universally implemented; high risk (HR)(D+/R-) and intermediate risk (IR)(R+) patients received 6 months while low risk (LR)(D-/R-) patients received 3 months. Primary outcomes included any CMV DNAemia, CMV DNAemia >1000 IU/mL and long term outcomes including rejection, graft failure, hepatic steatosis (HS), and de novo autoimmune hepatitis (AIH). Associations with CMV DNAemia were measured using Fisher …