Nationwide Survey of Human T Cell Leukemia Virus Type 1-Infected Kidney Transplant Recipients in Japan

J. Yamauchi¹, Y. Yamano¹, M. Matsuoka², N. Ichimaru³, M. Nishikido⁴, Y. Shibagaki⁵, A. Sugitani⁶, N. Nakamura⁷, M. Mieno⁸, K. Yuzawa⁹

¹Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki, Japan, ²Institute for Virus Research, Kyoto University, Kyoto, Japan, ³Advanced Technology for Transplantation, Osaka University, Osaka, Japan, ⁴Blood Purification Center, Nagasaki University, Nagasaki, Japan, ⁵Department of Nephrology and Hypertention, St. Marianna University School of Medicine, Kawasaki, Japan, ⁶NHO Yonago Medical Center, Yonago, Japan, ⁷Fukuoka University, Fukuoka, Japan, ⁸Center for Information, Jichi Medical University, Shimotsuke, Japan, ⁹Department of Transplantation Surgery, National Hospital Organization Mito Medical Center, Ibaraki, Japan

Meeting: 2019 American Transplant Congress

Abstract number: 461

Keywords: Infection, Kidney transplantation, Screening

Session Information

Session Name: Concurrent Session: Novel Insights in Kidney Infections

Session Type: Concurrent Session

Date: Tuesday, June 4, 2019

Session Time: 2:30pm-4:00pm

Presentation Time: 2:54pm-3:06pm

Location: Room 311

*Purpose: Human T-cell leukemia virus type 1 (HTLV-1) infects 5 to 10 million people worldwide, and is endemic in Japan, sub-Saharan Africa, South America, and etc. HTLV-1 causes the devastating neurological disorder HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and adult T-cell leukemia/lymphoma (ATL). The purpose of this study was to reveal the incidence of HTLV-1-related diseases among HTLV-1-positive kidney transplant (KT) recipients in Japan.

*Methods: We found KT recipients who were HTLV-1-positive before the KT or who received the kidney from HTLV-1-positive donors, using the Japanese Renal Transplant Registry between 2000 and 2014, which records all KT in Japan. Then, we investigated the onset of HAM/TSP and ATL among those recipients by sending questionnaires to the hospitals where the KT were performed.

*Results: We obtained the patient information of 10 HTLV-1-positive donors to HTLV-1-negative recipients (D+/R-), 30 D+/R+, and 59 D-/R+ KT. The median post-KT follow-up was 4.5 years (range, 0.1-13.4). HAM/TSP developed in four (40.0%) of 10 D+/R- recipients, exhibiting a much higher risk compared with D+/R+ (0%, 0/30) and D-/R+ (1.7%, 1/59) recipients. The median duration from KT to the onset of HAM/TSP in D+/R- recipients was 3.8 years (range, 1.3-8.4). As for ATL, one (1.7%) of 59 D-/R+ recipients was reported to develop ATL 10 years after KT. Neither D+/R- nor D+/R+ recipient developed ATL.

*Conclusions: Our survey demonstrated that the primary infection of HTLV-1 through D+/R- KT frequently causes HAM/TSP within a short incubation time. On the other hand, KT to HTLV-1-positive recipients did not have the high risk even if receiving kidneys from HTLV-1-positive donors. Therefore, HTLV-1 screening is important especially for donors from endemic areas to avoid D+/R- KT.

To cite this abstract in AMA style:

Yamauchi J, Yamano Y, Matsuoka M, Ichimaru N, Nishikido M, Shibagaki Y, Sugitani A, Nakamura N, Mieno M, Yuzawa K. Nationwide Survey of Human T Cell Leukemia Virus Type 1-Infected Kidney Transplant Recipients in Japan [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/nationwide-survey-of-human-t-cell-leukemia-virus-type-1-infected-kidney-transplant-recipients-in-japan/. Accessed May 11, 2025.

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