Strategic Help With Immunoglobulin to Enhance Protect Against Late Disease (CMV)

Inclusion Criteria * High risk pretransplant CMV donor seropositive/recipient seronegative (D+R-) kidney, liver, or simultaneous liver-kidney (SLK) transplant recipients * Able to do routine blood testing (normal care for transplant recipients) * Written informed consent obtained from the subject before any trial-related procedures * Be ≥18 years and ≤75 years of age at time of consent Exclusion Criteria * Any pre-transplant CMV serologic combinations besides CMV D+/R- * Multi organ transplants (other than simultaneous liver-kidney transplant (SLK) recipients) or prior history of bone marrow or stem cell transplant * Lung, heart, small bowel, pancreas, or other non-kidney or non-liver transplant recipients * Transplant recipients treated for rejection within three months before the end of valganciclovir prophylaxis * Participation in another interventional clinical trial at time of consent or within 30 days prior to study consent * Transplant recipients with eGFR \<30 ml/min/1.73m2 (as they theoretically could be at higher risk for renal impairment with CMV immunoglobulin), poor transplant organ function (i.e. LFTs \> twice the upper limit of normal in liver recipients), or who are on dialysis, or plasmapheresis, or who are relisted for transplant, or who might otherwise at risk of complications at the discretion of the local site investigator. * Those with a history of severe reaction to CMV immunoglobulin (e.g. CytoGam® or similar) or other human immunoglobulin preparati…