What does this research mean for the field?

Higher pre-transplant Torque Teno Virus (TTV) load in lung transplant recipients is associated with an increased risk of early infection and 1-year graft failure, but a decreased risk of acute rejection. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The study aims to determine the association of pre-transplant TTV load with early outcomes post-lung transplantation.

March 24, 2026Open Access

Association of Pre-Transplant Torque Teno Virus Load With Early Post-Transplant Outcomes in Lung Transplant Recipients: A Multicenter Cohort Study

Key Result

Each 1-log10 increase in pre-transplant TTV load in lung recipients increased early infection risk (aOR 15.05) and 1-year graft failure (aHR 1.40), but reduced acute rejection (aHR 0.70).

Key Points

The study aims to determine the association of pre-transplant TTV load with early outcomes post-lung transplantation.
Conducted a multicenter cohort study involving 334 first-time lung transplant recipients.
Plasma samples were collected before transplantation to measure TTV levels.
Primary endpoint assessed was infection within 3 months post-transplant.
Used multivariable logistic regression and time-to-event analyses to evaluate outcomes.
Pre-transplant TTV levels were significantly higher in transplant recipients compared to controls.
30.8% of recipients developed early infections; those with infections had higher TTV levels.
Each 1-log₁₀ increase in TTV correlated with a significantly higher infection risk.
Higher TTV levels were linked to lower acute rejection risks and increased 1-year graft failure rates.

Structured PICO

Does pre-transplant Torque teno virus (TTV) load predict early post-transplant infection, acute rejection, and 1-year graft failure in lung transplant recipients?

Population

334 adult first-time lung transplant recipients (2015–2022) from 6 major centers in Korea, excluding those with missing plasma, hemolysis, or re-transplantation. 100 healthy individuals served as controls.

Intervention

Pre-transplant plasma Torque teno virus (TTV) load measurement

Comparator

Lower pre-transplant TTV levels (<7.38 log10 copies/mL) or healthy controls

Outcome

Infection within 3 months post-transplantationhard clinical

Higher pre-transplant plasma TTV load is a strong predictor of early post-transplant infection and 1-year graft failure, but is associated with fewer acute rejection events, highlighting its potential as a biomarker for immune risk stratification.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

AbstractBackground 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; pConclusions 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.

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