The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2026
Association of pre-transplant torque teno virus load with early post-transplant outcomes in lung transplant recipients: A multicenter cohort study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Lee HyunJi, Cho Woo Hyun, Kim Kipoong, Kim A Reum, Oh Seung-Hwan, Lee Jin Gu, Kim Song Yee, Park Samina, Jeon Kyeongman, Hong Hanpyo, Yeo Hye Ju, KOTRY study group
Аннотация
BACKGROUND: Torque teno virus (TTV) load has emerged as a potential surrogate marker of net immunosuppression in solid organ transplantation. However, the clinical significance of pre-transplant TTV levels for early outcomes after lung transplantation remains unclear.
METHODS: In this multicenter cohort of 334 adult first-time lung transplant recipients (2015-2022), plasma samples were collected immediately prior to transplantation. The primary endpoint was infection within 3 months. One hundred healthy individuals served as controls for TTV comparisons. Secondary outcomes were acute rejection and 1-year graft failure. Associations were evaluated using multivariable logistic regression for early infection and time-to-event analyses for rejection and graft failure.
RESULTS: Pre-transplant TTV levels were higher in recipients than in controls (6.7 vs 5.9 log₁₀ copies/mL; p<0.001). Early infections occurred in 103 patients (30.8%). Patients with infection had higher pre-transplant TTV levels than those without infection (7.8 vs 6.3 log₁₀ copies/mL; p<0.001). Each 1-log₁₀ increase in TTV was associated with higher infection risk (adjusted odds ratio 15.05; 95% CI 7.25-31.20; p<0.001). Receiver operating characteristic analysis showed good discrimination for identifying early infection (AUC 0.89; 95% CI 0.85-0.92). Higher TTV levels were associated with lower acute rejection risk (adjusted hazard ratio 0.70; 95% CI 0.56-0.87; p = 0.001) and higher 1-year graft failure (adjusted hazard ratio 1.40; 95% CI 1.13-1.74; p = 0.002).
CONCLUSIONS: Pre-transplant plasma TTV load was associated with early infection, fewer rejection events, and increased 1-year graft failure after lung transplantation, supporting its potential role as a biomarker for immune risk stratification.
METHODS: In this multicenter cohort of 334 adult first-time lung transplant recipients (2015-2022), plasma samples were collected immediately prior to transplantation. The primary endpoint was infection within 3 months. One hundred healthy individuals served as controls for TTV comparisons. Secondary outcomes were acute rejection and 1-year graft failure. Associations were evaluated using multivariable logistic regression for early infection and time-to-event analyses for rejection and graft failure.
RESULTS: Pre-transplant TTV levels were higher in recipients than in controls (6.7 vs 5.9 log₁₀ copies/mL; p<0.001). Early infections occurred in 103 patients (30.8%). Patients with infection had higher pre-transplant TTV levels than those without infection (7.8 vs 6.3 log₁₀ copies/mL; p<0.001). Each 1-log₁₀ increase in TTV was associated with higher infection risk (adjusted odds ratio 15.05; 95% CI 7.25-31.20; p<0.001). Receiver operating characteristic analysis showed good discrimination for identifying early infection (AUC 0.89; 95% CI 0.85-0.92). Higher TTV levels were associated with lower acute rejection risk (adjusted hazard ratio 0.70; 95% CI 0.56-0.87; p = 0.001) and higher 1-year graft failure (adjusted hazard ratio 1.40; 95% CI 1.13-1.74; p = 0.002).
CONCLUSIONS: Pre-transplant plasma TTV load was associated with early infection, fewer rejection events, and increased 1-year graft failure after lung transplantation, supporting its potential role as a biomarker for immune risk stratification.