Torque Teno Virus Load Is Associated With Subclinical Alloreactivity in Kidney Transplant Recipients: A Prospective Observational Trial

Doberer, Konstantin; Haupenthal, Frederik; Nackenhorst, Maja; Bauernfeind, Florian; Dermuth, Florentina; Eigenschink, Michael; Schiemann, Martin; Kläger, Johannes; Görzer, Irene; Eskandary, Farsad; Reindl‐Schwaighofer, Roman; Kikić, Željko; Böhmig, Georg A.; Straßl, Robert; Regele, Heinz; Puchhammer‐Stöckl, Elisabeth; Bond, Gregor

doi:10.1097/tp.0000000000003619

Cited by 39 publications

(57 citation statements)

References 15 publications

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“…Various studies have investigated the performance of TTV kinetics to predict acute rejection after KT, [54][55][56][73][74][75] LT 57,87 and LuT. 59,60,67 In a single-center study with 63 KT recipients, Solis et al found that those with TTV DNA load below 3.4 log 10 copies/ml at the time of transplantation or below 4.2 log 10 copies/ml by month 1 exhibited a 6-to-7-fold increase in the risk of graft rejection (mainly TCMR) within the next two years.…”

Section: Association Between Ttv Load and Acute Graft Rejectionmentioning

confidence: 99%

“…In addition, various studies have reported a direct correlation between TTV DNA loads and trough CNI levels over the previous weeks, 58,59 although this finding has not been consistently replicated 54,57,60,69 . An inverse correlation between the time interval since transplantation and viral load has been observed in studies based on prevalent, rather than incident, KT recipients 54–56,72–75 …”

Section: Torque Teno Virus In Solid Organ Transplantationmentioning

confidence: 99%

“…Various studies have investigated the performance of TTV kinetics to predict acute rejection after KT, 54–56,73–75 LT 57,87 and LuT 59,60,67 . In a single‐center study with 63 KT recipients, Solis et al.…”

Section: Torque Teno Virus In Solid Organ Transplantationmentioning

confidence: 99%

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Viruses, friends, and foes: The case of Torque Teno Virus and the net state of immunosuppression

Redondo

Navarro

Paz‐Artal

et al. 2022

Transplant Infectious Dis

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Section: Association Between Ttv Load and Acute Graft Rejectionmentioning

confidence: 99%

Section: Torque Teno Virus In Solid Organ Transplantationmentioning

confidence: 99%

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Viruses, friends, and foes: The case of Torque Teno Virus and the net state of immunosuppression

Redondo

Navarro

Paz‐Artal

et al. 2022

Transplant Infectious Dis

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“…Cytokines, chemokines [15,16] ImmunoKnow-Assay [17][18][19][20][21] TorqueTenoVirus [16,[22][23][24][25][26][27][28][29] Virus-specific T cells [30][31][32][33][34] Ahlenstiel-Grunow and Pape Molecular and Cellular Pediatrics (2021) 8:8…”

Section: Methods Studiesmentioning

confidence: 99%

“…TTV load increases under immunosuppressive therapy, and replication is inversely correlated with the number and function of T cells [22][23][24]. Several studies reported an association of TTV load with the post-transplant presence of infections or rejections [16,[25][26][27], and recently, an observational trial confirmed that high TTV load is related to an increased risk of post-transplant infections and decreased risk of rejections after kidney transplantation [28]. However, in liver-transplanted children, it was reported that TTV replication is influenced not only by immune status but also by viral coinfection resulting in lower TTV load in case of hepatitis E virus infection [29].…”

Section: Methods Studiesmentioning

confidence: 99%

Novel ways to monitor immunosuppression in pediatric kidney transplant recipients—underlying concepts and emerging data

Ahlenstiel-Grunow

Pape

2021

Mol Cell Pediatr

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After pediatric kidney transplantation, immunosuppressive therapy is given to avoid acute and chronic rejections. However, the immunosuppression causes an increased risk of severe viral complications and bacterial infections and is associated with serious side effects. It is therefore crucial to achieve the optimal individual balance between over- and under-immunosuppression and thereby avoid unnecessary exposure to immunosuppressive drugs. In routine use, steering of immunosuppressants is performed primarily by monitoring of trough levels that mirror pharmacokinetics (although not, however, pharmacodynamics). Other diagnostic and prognostic markers to assess the individual intensity of immunosuppression are missing. Potential methods to determine immune function and grade of immunosuppression, such as analysis of the torque teno virus (TTV) load, QuantiFERON Monitor®, and ImmuKnow® as well as virus-specific T cells (Tvis), are currently being evaluated. In some studies TTV load, QuantiFERON Monitor® and ImmuKnow® were associated with the risk for post-transplant rejections and infections, but randomized controlled trials after pediatric kidney transplantation are not available. Post-transplant monitoring of Tvis levels seem to be promising because Tvis control virus replication and have been shown to correlate with virus-specific as well as general cellular immune defense, which represents the individual’s susceptibility to infections. Additional Tvis-monitoring provides an innovative opportunity to personalize the antiviral management and the dosing of the immunosuppressive therapy after pediatric kidney transplantation to avoid unnecessary therapeutic interventions and identify over-immunosuppression.

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Torque‐teno virus for the prediction of graft rejection and infection disease after kidney transplantation: A systematic review and meta‐analysis

Zeng

Tang

Lin

et al. 2023

Journal of Medical Virology

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Torque teno virus (TTV) is a promising novel marker for quantifying the immune function in solid organ recipients, whose diagnostic accuracy of acute rejection (AR) and infection after kidney transplantation (KT) has not been evaluated. We performed a systematic review and meta-analysis to evaluate the diagnostic accuracy of TTV for discriminating AR and infection after KT. Eleven studies were included in the meta-analysis. Seven studies focused on the diagnostic accuracy of TTV for AR, and the pooled analysis indicated patients who developed AR had a significant lower TTV viral DNA load (log 10 copies/mL, MD: −0.74, p < 0.01). The pooled sensitivity, specificity, and area under the receiver operating characteristics curve for TTV in AR differentiation were 0.61 (0.36−0.82), 0.81 (0.64−0.91), and 0.79 (0.75−0.82), respectively. The overall diagnostic odds ratio (DOR) was 6.74(2.60−17.50), positive likelihood ratio (PLR) was 3.22 (1.75−5.95), and negative likelihood ratio (NLR) was 0.48 (0.27−0.84), respectively. Similarly, seven studies investigated the infection discrimination and found that patients who subsequently developed posttransplant infection had higher plasma TTV DNA loads (log 10 copies/ mL, MD: 0.65; p < 0.01) than those remaiing infection-free. Pooled sensitivity, specificity, and area under the receiver operating characteristics curve for TTV in infection differentiation were 0.72 (0.39−0.91), 0.57 (0.30−0.80), and 0.68 (0.64−0.72), respectively. The overall DOR was 3.28 (95% confidence interval [CI]: 2.08−5.17), the pooled PLR and NLR were 1.65 (95% CI: 1.25−2.18) and 0.50 (95% CI: 0.29−0.86), respectively. TTV might be a modest indicator for risk stratification of AR after KT, but it is a poor to discriminate posttransplant infection.

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Torque Teno Virus Load Is Associated With Subclinical Alloreactivity in Kidney Transplant Recipients: A Prospective Observational Trial

Abstract: Supplemental Digital Content is available in the text.

Cited by 39 publications

References 15 publications

Viruses, friends, and foes: The case of Torque Teno Virus and the net state of immunosuppression

Viruses, friends, and foes: The case of Torque Teno Virus and the net state of immunosuppression

Novel ways to monitor immunosuppression in pediatric kidney transplant recipients—underlying concepts and emerging data

Torque‐teno virus for the prediction of graft rejection and infection disease after kidney transplantation: A systematic review and meta‐analysis

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