Potential mortality benefit from secondary prophylaxis following CMV treatment completion may be due to confounding by transplant organ type.

We have read with interest the paper by Serrano-Alonso et al. regarding outcomes in solid organ transplant recipients who did and did not receive secondary prophylaxis (SP) following a treated episode of CMV disease. This study included 126 heart, liver and kidney transplant recipients of whom 103 (83%) received SP for a mean duration of 49 ± 29 days. Consistent with our recently published study and others, there was no overall benefit in terms of CMV relapse with the use of SP. Death, however, occurred in 6/103 (6%) patients who received SP compared to 6/21 (29%) who did not. This article is protected by copyright. All rights reserved.