Abstract: TH-PO801
Single-Center Observational Study of Torque Teno Virus in Mainly Steroid-Free Adult and Pediatric Kidney Transplant Recipients
Session Information
- Transplantation: Clinical - 2
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Gramkow, Ann-Maria, Odense Universitetshospital, Odense, Syddanmark, Denmark
- Thiesson, Helle C., Odense Universitetshospital, Odense, Syddanmark, Denmark
- Nørgaard, Maja, Aarhus Universitetshospital, Aarhus, Denmark
- Koefoed-Nielsen, Pernille, Aarhus Universitetshospital, Aarhus, Denmark
- Berg, Randi, Aarhus Universitetshospital, Aarhus, Denmark
Background
Torque Teno Virus (TTV), an apathogenic single-stranded anellovirus, is prevalent in solid organ transplant recipients. Evidence suggests that its replication varies with immunosuppression after transplantation.
This study investigates TTV correlations with rejection and infections in kidney transplant recipients and assesses the impact of steroid-free versus steroid-containing therapy. It explores individual TTV trajectories over time and compares TTV dynamics and levels between adult and pediatric recipients.
Methods
We prospectively collected 1704 samples from 310 adults and 20 pediatric recipients after transplantation. All recipients received tacrolimus and mycophenolate mofetil; 27% also received prednisolone, while the remainder were steroid-free. TTV was quantified with an in-house rtPCR assay. Cox regression models assessed TTV's association with rejection and infections, while mixed effects linear regression models analyzed other outcomes.
Results
We observed a decreased hazard ratio for rejection (HR 0.90, 95% CI: 0.82-0.99) with increasing TTV load but no association with infections (HR 1.00, 95% CI: 0.97-1.03).
TTV levels were 0.66 (95% CI: 0.42-0.90) log10 copies/ml higher in recipients receiving prednisolone than those not receiving prednisolone (p<0.001).
Stratification by TTV levels at transplantation revealed significant differences in levels over time: 2.51 (95% CI: 2.32-2.69) log10 copies/ml in the first tertile, 4.32 (95% CI: 4.02-4.62) in the second, and 5.02 (95% CI: 4.77-5.26) in the third.
TTV peaked three months post-transplantation, then declined to stabilize, with no significant differences between adult and pediatric recipients.
Conclusion
We observed decreasing TTV levels correlated with increased rejection risk, but no association with infections. Notably, steroid use increased TTV levels, suggesting caution extrapolating TTV thresholds established from steroid-based regimens on steroid-free populations. Recipients with low TTV levels at transplantation maintained this trend over time. Further research is warranted to explore individual TTV trajectories. No differences in TTV level or dynamic were observed between adult and pediatric recipients, supporting the applicability of TTV in pediatric recipients.
Funding
- Private Foundation Support