Effect of delaying prophylaxis against CMV in D+/R− solid organ transplant recipients in the development of CMV-specific cellular immunity and occurrence of late CMV disease

•We compared early and 14-days delayed long term prophylaxis in 95 D+/R− solid organ transplants.•We analyzed CMV-specific immunity and CMV disease among both groups of prophylaxis.•A 14-day delay in CMV prophylaxis is safe with no cases of early CMV disease.•There was a clear trend towards less end-organ CMV disease in patients receiving delayed prophylaxis.•CMV-specific immunity was not significantly improved by delaying CMV prophylaxis.