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Abstract:  Background:  Cytomegalovirus (CMV) infection of solid organ transplant (SOT) recipients causes both ‘‘direct’’ and ‘‘indirect’’ effects including allograft rejection, decreased graft and patient survival, and predisposition to opportunistic infections and malignancies. Options for CMV prevention include pre‐emptive therapy, whereby anti‐CMV agents are administered based on sensitive viral assays, or universal prophylaxis of all at‐risk patients. Each approach has advantages and disadvantages in terms of efficacy, costs, and side effects. Standards of care for prophylaxis have not been established.

Methods:  A committee of international experts was convened to review the available data regarding CMV prophylaxis and to compare preventative strategies for CMV after transplantation from seropositive donors or in seropositive recipients.

Results:  Pre‐emptive therapy requires frequent monitoring with …