| Autor: |
Gore EJ; Department of Medical Microbiology, Rijksuniversiteit Groningen, University Medical Centre Groningen, 9713GZ Groningen, The Netherlands., Gomes-Neto AW; Department of Internal Medicine, Rijksuniversiteit Groningen, University Medical Centre Groningen, 9713GZ Groningen, The Netherlands., Wang L; Department of Rheumatology and Clinical Immunology, Rijksuniversiteit Groningen, University Medical Centre Groningen, 9713GZ Groningen, The Netherlands., Bakker SJL; Department of Internal Medicine, Rijksuniversiteit Groningen, University Medical Centre Groningen, 9713GZ Groningen, The Netherlands., Niesters HGM; Department of Medical Microbiology, Rijksuniversiteit Groningen, University Medical Centre Groningen, 9713GZ Groningen, The Netherlands., de Joode AAE; Department of Internal Medicine, Rijksuniversiteit Groningen, University Medical Centre Groningen, 9713GZ Groningen, The Netherlands., Verschuuren EAM; Department of Pulmonology, Rijksuniversiteit Groningen, University Medical Centre Groningen, 9713GZ Groningen, The Netherlands., Westra J; Department of Rheumatology and Clinical Immunology, Rijksuniversiteit Groningen, University Medical Centre Groningen, 9713GZ Groningen, The Netherlands., Leer-Buter CV; Department of Medical Microbiology, Rijksuniversiteit Groningen, University Medical Centre Groningen, 9713GZ Groningen, The Netherlands. |
| Abstrakt: |
Following transplantation, patients must take immunosuppressive medication for life. Torquetenovirus (TTV) is thought to be marker for immunosuppression, and TTV-DNA levels after organ transplantation have been investigated, showing high TTV levels, associated with increased risk of infections, and low TTV levels associated with increased risk of rejection. However, this has been investigated in studies with relatively short follow-up periods. We hypothesized that TTV levels can be used to assess long term outcomes after renal transplantation. Serum samples of 666 renal transplant recipients were tested for TTV DNA. Samples were taken at least one year after renal transplantation, when TTV levels are thought to be relatively stable. Patient data was reviewed for graft failure, all-cause mortality and death due to infectious causes. Our data indicates that high TTV levels, sampled more than one year post-transplantation, are associated with all-cause mortality with a hazard ratio (HR) of 1.12 (95% CI, 1.02-1.23) per log 10 increase in TTV viral load, ( p = 0.02). Additionally, high TTV levels were also associated with death due to infectious causes (HR 1.20 (95% CI 1.01-1.43), p = 0.04). TTV levels decrease in the years following renal transplantation, but remain elevated longer than previously thought. This study shows that TTV level may aid in predicting long-term outcomes, all-cause mortality and death due to an infectious cause in renal transplant patients sampled over one year post-transplantation. |
