HTLV Screening among Solid Organ Transplant Candidates at a Large Transplant Center

J. Simkins¹, J. A. Morillas-Rodriguez¹, M. I. Morris¹, L. M. Abbo¹, J. F. Camargo¹, S. Anjan¹, W. Kupin¹, P. Ruiz², C. Fernandez-Bango², J. C. Ramos¹

¹Medicine, University of Miami, Miami, FL, ²Surgery, University of Miami, Miami, FL

Meeting: 2019 American Transplant Congress

Abstract number: A364

Keywords: Screening

Session Information

Session Name: Poster Session A: Transplant Infectious Diseases

Session Type: Poster Session

Date: Saturday, June 1, 2019

Session Time: 5:30pm-7:30pm

Presentation Time: 5:30pm-7:30pm

Location: Hall C & D

*Purpose: Data on human T-lymphotropic virus (HTLV) seroprevalence among solid organ transplant (SOT) candidates and risk of HTLV complications after SOT is scarce. HTLV-I is associated with adult T cell leukemia/lymphoma (ALT) and HTLV-I associated myelopathy (HAM)/tropical spastic paraparesis (TSP). Historically, HTLV-II has not been clearly associated with any diseases. Although, HTLV-II has also been linked with HAM/TSP in some reports.

*Methods: This retrospective study was performed to evaluate the seroprevalence of HTLV among SOT candidates that were screened from 12/2014 to 12/2016 and the incidence of HTLV complications (ALT and HAM/TSP) for those who underwent SOT. All post-transplant records up to 11/2018 were reviewed. AVIOQ® HTLV-I/II Microelisa System was used for HTLV I and II antibodies detection.

*Results: 5,662 SOT candidates were screened for HTLV-I/II. 4,459(78.8%) were evaluated for kidney transplant, 785(13.9%) for liver, 116(2%) for kidney/pancreas, 115(2%) for heart, 77(1.4%) for liver/kidney, 54(1%) for lung, 44(0.8%) for intestinal, and 12 for other transplants. 36(0.6%) SOT candidates tested positive for HTLV (HTLV-I in 18, and HTLV-II and untypable in 9 each). There were no differences in age and gender between HTLV-I and II patients [age: 60.2±10.7 vs. 61±5 years, P=0.83, and male: 11(61.1%) vs. 5(55.6%), P>0.99, respectively]. HTLV-I carriers were more likely to have born in the Caribbean [11(61.1%) vs. 1(11.1%), P=0.02]. A positive Strongyloides IgG was seen in 3(16.7%) of the HTLV-I positive patients, one of whom (patient #3 in Table 1) underwent kidney transplant and received ivermectin 0.2mg/Kg PO monthly for the 1^st year after SOT and developed no symptoms of Strongyloides reactivation. Thirteen (36.1%) of the HTLV-positive patients [HTLV-I (6 patients), HTLV-II (4) and untypable HTLV (3)] underwent SOT (Table 1 and 2). None of these developed HTLV complications after SOT. The post-transplant follow-up duration was 766.7±373.3 days.

*Conclusions: The HTLV seroprevalence was low among our cohort of SOT candidates. Transplantation in HTLV carriers appears to be safe but larger studies with longer follow-up are needed.

Table 1. Characteristics of patients with HTLV-I who underwent SOT
Patients	Age	Gender	Country of Origin	Type of SOT	Post-transplant follow-up time (days)
1	63	M	Granada	Kidney	377
2	61	M	Haiti	Kidney	1113
3	46	F	US	Kidney	525
4	30	M	US	Kidney	545
5	71	F	Jamaica	Kidney	468
6	66	M	Jamaica	Kidney	556

Table 2. Characteristics of patients with HTLV-II and untypable HTLV who underwent SOT
Patients	Age	Gender	Country of Origin	Type of HTLV	Type of SOT	Post-transplant follow-up time (days)
7	65	M	US	II	Kidney	1142
8	63	M	US	II	Liver/Kidney	493
9	60	F	US	II	Liver	1307
10	61	M	US	II	Liver	790
11	26	M	US	Untypable	Kidney	281
12	53	F	Unclear	Untypable	Kidney	1366
13	66	M	US	Untypable	Liver/Kidney	1004

To cite this abstract in AMA style:

Simkins J, Morillas-Rodriguez JA, Morris MI, Abbo LM, Camargo JF, Anjan S, Kupin W, Ruiz P, Fernandez-Bango C, Ramos JC. HTLV Screening among Solid Organ Transplant Candidates at a Large Transplant Center [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/htlv-screening-among-solid-organ-transplant-candidates-at-a-large-transplant-center/. Accessed November 22, 2024.

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