Torque Teno Virus Load Predicts Allograft Rejection but Not Viral Infection After Kidney Transplantation; A Cohort Joint Modelling Study
1Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands, 2Medical Microbiology, University Medical Center Utrecht, Utrecht, Netherlands, 3Medical Statistics, Leiden University Medical Center, Leiden, Netherlands, 4Internal Medicine, Leiden University Medical Center, Leiden, Netherlands
Meeting: 2021 American Transplant Congress
Abstract number: LB 29
Keywords: Infection, Kidney transplantation, Rejection, Risk factors
Topic: Clinical Science » Biomarkers, Immune Assessment and Clinical Outcomes
Session Information
Session Name: Biomarkers, Immune Assessment and Clinical Outcomes
Session Type: Poster Abstract
Session Date & Time: None. Available on demand.
Location: Virtual
*Purpose: The main challenge of immunosuppressive therapy after solid organ transplantation is to find the optimal dose regimen, and prevent allograft rejection as well as opportunistic infection. Torque teno virus (TTV; ubiquitous and non-pathogenic) has been proposed as a marker of functional immunity in immunocompromised patients. We investigate whether TTV loads predict the risk of common viral infection and allograft rejection in kidney transplantation (KTx) recipients.
*Methods: In a retrospective cohort of 389 KTx recipients, individual TTV loads in were measured by qPCR in consecutive plasma samples during one year follow-up. The endpoints were allograft rejection, BK polyomavirus (BKPyV) viremia and cytomegalovirus (CMV) viremia. Repeated measures and survival data were analysed in a joint model.
*Results: During follow-up TTV was detected in 100% of KTx recipients. The median viral load increased to 107 genome copies/ml 3 months after KTx. Rejection, BKPyV viremia and CMV viremia occurred in 23%, 27% and 17% of the patients, respectively. With every 10-fold TTV load-increase, the risk of rejection decreased considerably (HR: 0.74, CI 95%: 0.71-0.76), while the risk of BKPyV and CMV viremia remained the same (HR: 1.03, CI 95%: 1.03-1.04 and HR: 1.01, CI 95%: 1.01-1.01).
*Conclusions: In conclusion, TTV load kinetics predict allograft rejection in KTx recipients, but not the BKPyV and CMV infection. The potential use of TTV load levels as a guide for optimal immunosuppressive drug dosage to prevent allograft rejection deserves further validation.
To cite this abstract in AMA style:
Rijn ALvan, Wunderink HF, Sidorov IA, Brouwer CSde, Kroes AC, Putter H, Vries APde, Rotmans JI, Feltkamp MC. Torque Teno Virus Load Predicts Allograft Rejection but Not Viral Infection After Kidney Transplantation; A Cohort Joint Modelling Study [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/torque-teno-virus-load-predicts-allograft-rejection-but-not-viral-infection-after-kidney-transplantation-a-cohort-joint-modelling-study/. Accessed December 11, 2024.« Back to 2021 American Transplant Congress