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. 2017 Feb;101(2):360-367.
doi: 10.1097/TP.0000000000001455.

Torque Teno Virus Load-Inverse Association With Antibody-Mediated Rejection After Kidney Transplantation

Martin Schiemann  1 , Elisabeth Puchhammer-Stöckl, Farsad Eskandary, Philip Kohlbeck, Susanne Rasoul-Rockenschaub, Andreas Heilos, Nicolas Kozakowski, Irene Görzer, Željko Kikić, Harald Herkner, Georg A Böhmig, Gregor Bond
Affiliations

Torque Teno Virus Load-Inverse Association With Antibody-Mediated Rejection After Kidney Transplantation

Martin Schiemann et al. Transplantation. 2017 Feb.

Abstract

Background: Antibody-mediated rejection (AMR) represents one of the cardinal causes of late allograft loss after kidney transplantation, and there is great need for noninvasive tools improving early diagnosis of this rejection type. One promising strategy might be the quantification of peripheral blood DNA levels of the highly prevalent and apathogenic Torque Teno virus (TTV), which might mirror the overall level of immunosuppression and thus help determine the risk of alloimmune response.

Methods: To assess the association between TTV load in the peripheral blood and AMR, 715 kidney transplant recipients (median, 6.3 years posttransplantation) were subjected to a systematical cross-sectional AMR screening and, in parallel, TTV quantification.

Results: Eighty-six of these recipients had donor-specific antibodies and underwent protocol biopsy, AMR-positive patients (n = 46) showed only 25% of the TTV levels measured in patients without AMR (P = 0.003). In a generalized linear model, higher TTV levels were associated with a decreased risk for AMR after adjustment for potential confounders (risk ratio 0.94 per TTV log level; 95% confidence interval 0.90-0.99; P = 0.02).

Conclusions: Future studies will have to clarify whether longitudinal assessment of TTV load might predict AMR risk and help guide the type and intensity of immunosuppression to prevent antibody-mediated graft injury.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
TTV load in peripheral blood in relation to time after kidney transplantation. Box plots indicate median, IQR, and range.
Figure 2
Figure 2
TTV load in peripheral blood in relation to ABMR diagnosis (A: overall cohort; B: DSA+ recipients subjected to protocol biopsy). Box plots indicate median, IQR, and range.
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Comment in

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