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.
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.
Authors: L Liefeldt; S Brakemeier; P Glander; J Waiser; N Lachmann; C Schönemann; B Zukunft; P Illigens; D Schmidt; K Wu; B Rudolph; H-H Neumayer; K Budde Journal: Am J Transplant Date: 2012-02-02 Impact factor: 8.086
Authors: E D Han Lee; C C Kemball; J Wang; Y Dong; D C Stapler; K M Hamby; S Gangappa; K A Newell; T C Pearson; A E Lukacher; C P Larsen Journal: Am J Transplant Date: 2006-05 Impact factor: 8.086
Authors: Farsad Eskandary; Gregor Bond; Nicolas Kozakowski; Heinz Regele; Lena Marinova; Markus Wahrmann; Željko Kikić; Helmuth Haslacher; Susanne Rasoul-Rockenschaub; Christopher C Kaltenecker; Franz König; Luis G Hidalgo; Rainer Oberbauer; Philip F Halloran; Georg A Böhmig Journal: Transplantation Date: 2017-03 Impact factor: 4.939
Authors: Tingting Chen; Elina Väisänen; Petri S Mattila; Klaus Hedman; Maria Söderlund-Venermo Journal: J Gen Virol Date: 2012-10-31 Impact factor: 3.891
Authors: Flavio Vincenti; Lionel Rostaing; Joseph Grinyo; Kim Rice; Steven Steinberg; Luis Gaite; Marie-Christine Moal; Guillermo A Mondragon-Ramirez; Jatin Kothari; Martin S Polinsky; Herwig-Ulf Meier-Kriesche; Stephane Munier; Christian P Larsen Journal: N Engl J Med Date: 2016-01-28 Impact factor: 91.245
Authors: M Haas; B Sis; L C Racusen; K Solez; D Glotz; R B Colvin; M C R Castro; D S R David; E David-Neto; S M Bagnasco; L C Cendales; L D Cornell; A J Demetris; C B Drachenberg; C F Farver; A B Farris; I W Gibson; E Kraus; H Liapis; A Loupy; V Nickeleit; P Randhawa; E R Rodriguez; D Rush; R N Smith; C D Tan; W D Wallace; M Mengel Journal: Am J Transplant Date: 2014-02 Impact factor: 8.086
Authors: E Albert; C Solano; E Giménez; D Focosi; A Pérez; L Macera; J L Piñana; J C H Boluda; F Maggi; D Navarro Journal: Bone Marrow Transplant Date: 2017-10-30 Impact factor: 5.483
Authors: Eliseo Albert; Carlos Solano; Estela Giménez; Daniele Focosi; Ariadna Pérez; Lisa Macera; José Luis Piñana; Eva María Mateo; Juan Carlos Hernández Boluda; Fabrizio Maggi; David Navarro Journal: Med Microbiol Immunol Date: 2019-03-09 Impact factor: 3.402
Authors: Konstantin Doberer; Michael Duerr; Philip F Halloran; Farsad Eskandary; Klemens Budde; Heinz Regele; Jeff Reeve; Anita Borski; Nicolas Kozakowski; Roman Reindl-Schwaighofer; Johannes Waiser; Nils Lachmann; Sabine Schranz; Christa Firbas; Jakob Mühlbacher; Georg Gelbenegger; Thomas Perkmann; Markus Wahrmann; Alexander Kainz; Robin Ristl; Fabian Halleck; Gregor Bond; Edward Chong; Bernd Jilma; Georg A Böhmig Journal: J Am Soc Nephrol Date: 2020-12-18 Impact factor: 10.121
Authors: Konstantin Doberer; Martin Schiemann; Robert Strassl; Frederik Haupenthal; Florentina Dermuth; Irene Görzer; Farsad Eskandary; Roman Reindl-Schwaighofer; Željko Kikić; Elisabeth Puchhammer-Stöckl; Georg A Böhmig; Gregor Bond Journal: Am J Transplant Date: 2020-03-08 Impact factor: 8.086