Long Term Longitudinal TTV Measurements in Lung Transplant Recipients
1Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands, 2Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands
Meeting: 2022 American Transplant Congress
Abstract number: 1560
Keywords: Immunosuppression, Lung transplantation, Mortality, N/A
Topic: Basic Science » Basic Clinical Science » 17 - Biomarkers: Clinical Outcomes
Session Information
Session Name: Biomarkers: Clinical Outcomes
Session Type: Poster Abstract
Date: Tuesday, June 7, 2022
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: To investigate how levels of Torque Teno Virus (TTV), a virus which has been proposed as a marker for immunosuppression change over a period of time following lung transplantation (LTx).
*Methods: 39 LTx patients transplanted between August 2014 and April 2016 were enrolled. All patients received induction therapy with basiliximab and initial maintenance therapy with tacrolimus (targeted trough levels of between 7 and 10 ug/l from month four), prednisolone and mycophenolate mofetil. TTV loads were measured every 4-6 weeks in the first year after transplantation, every 12-16 weeks in the second year and every 6-12 months thereafter using the Biomerieux R-gene TTV detection kit. Patient data was recorded, including reasons for transplantation, rejections episodes, infections, drug level adjustments, development of lung function and outcome after 5 years.
*Results: At month one TTV was Log 5.49 [IQR 4.17 – 6.05], at month six log 6.90 [IQR 5.74 – 7.88]. Peak TTV occurred a median 160 [IQR 99 – 231] days post-transplantation and ranged between log 7.46 and log 8.27. Patient demographics is included in Table 1. Eight patients died during follow-up of these 37% died due to an infectious cause.
| Table 1. Patient demographics | |
| Female gender, n (%) | 23 (59) |
| Median Age | 54 |
| Reason for transplant, n (%) | |
| Emphysema | 16 (41) |
| Cystic Fibrosis | 4 (10) |
| Fibrotic disease | 4 (10) |
| Retransplant | 5 (13) |
| Other | 2 (5) |
| Mortality, n (%) | 8 (20) |
| Median survival, years (IQR) | 6.3 (5.9 – 6.7) |
*Conclusions: TTV has been investigated as a marker for immunosuppression following solid organ transplantation. This study is the first to investigate the TTV loads over a prolonged period of time (up to 5 years). Our data shows that lung transplant recipients have a wide range of TTV loads. In spite of all receiving similar immunosuppression, peak TTV levels range from undetectable values to log 8.91. This potentially indicates a significant discrepancy between the pharmacological and the biological effects of antirejection treatment.
The highest TTV loads were measured between three and eight months after transplantation, potentially indicating a reduced level of immunocompetence. This is of importance when considering when to stop prophylaxis, e.g for CMV. Additionally clinicians should be aware that their patients may be at a higher risk of post-transplant infection during this time frame.
To cite this abstract in AMA style:
Gore E, Rondaan C, Verschuuren EA, Gard L, Niesters HG, Leer-Buter Cvan. Long Term Longitudinal TTV Measurements in Lung Transplant Recipients [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/long-term-longitudinal-ttv-measurements-in-lung-transplant-recipients/. Accessed November 23, 2024.« Back to 2022 American Transplant Congress