{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T09:58:45Z","timestamp":1790416725298,"version":"4.1.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017590","name":"University Hospital of Essen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017590","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Pharmacokinetic monitoring is insufficient to estimate the intensity of immunosuppression after kidney transplantation (Tx). The randomized controlled IVIST trial demonstrated that additional steering of immunosuppressive therapy by virus-specific CD4+ T cells (Tvis) is safe and reduces exposure to immunosuppressants. The adenovirus-specific CD4+ T cells (ADV-Tvis) proved to be particularly suitable due to their stability and high prevalence. Another promising biomarker for post-Tx immunomonitoring is the Torque Teno virus (TTV) but pediatric data are very limited. This descriptive longitudinal analysis aimed to evaluate the post-Tx course of TTV load compared to Tvis levels after pediatric Tx.<\/jats:p>\n                  <jats:p>In the IVIST trial, 31 pediatric kidney recipients were randomized to the intervention group with Tvis-guided immunosuppression. The immunosuppressive therapy consisted of basiliximab, cyclosporine A (CsA), everolimus (Eve), and prednisolone. In 27 out of 31 intervention group patients, TTV-DNA was analysed retrospectively in frozen plasma samples from 20 visits [1\u201324 months (mo) after Tx]. Associations of TTV-DNA with ADV-Tvis and with immunosuppressants over the post-Tx period were evaluated using linear mixed models, adjusted for time since Tx and accounting for repeated measurements within patients.<\/jats:p>\n                  <jats:p>Mean TTV-DNA (n\u00a0=\u00a0474) \u00b1 standard deviation was 4.4\u00a0\u00b1\u00a01.3 log10 copies\/ml (1.4 to 9.4 log10). TTV-DNA was associated with post-Tx follow-up time. Under intensive immunosuppression immediately after Tx, TTV-DNA increased, peaking at 3\u00a0mo post-Tx (5.5\u00a0\u00b1\u00a01.4 log10); after reduction of immunosuppression, TTV load decreased (6 mo: 4.3\u00a0\u00b1\u00a01.1 log10; 16 mo: 3.9\u00a0\u00b1\u00a00.9 log10). Mean ADV-Tvis levels showed a minimum at 2\u00a0mo post-Tx and increased over time: from 1.5\u00a0\u00b1\u00a01.1 cells\/\u00b5l (2\u00a0mo) to 2.0\u00a0\u00b1\u00a01.8 cells\/\u00b5l (6\u00a0mo) and 2.4\u00a0\u00b1\u00a01.7 cells\/\u00b5l (22\u00a0mo). TTV-DNA showed overall positive correlations with mean daily doses and trough levels of CsA and Eve.<\/jats:p>\n                  <jats:p>The longitudinal analysis of TTV load presented an opposite post-Tx course compared to ADV-Tvis. TTV-DNA was associated with post-Tx follow-up time and with immunosuppressants after pediatric Tx. In comparison to ADV-Tvis minimum, the mean TTV-DNA showed a late peak at 3 mo post-Tx suggesting delayed response to drug dose changes.<\/jats:p>","DOI":"10.1093\/ckj\/sfag262","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:20:47Z","timestamp":1786706447000},"source":"Crossref","is-referenced-by-count":0,"title":["Immune monitoring by Torque Teno virus load in addition to virus-specific T cells after pediatric kidney transplantation"],"prefix":"10.1093","volume":"19","author":[{"given":"David","family":"Nehl","sequence":"first","affiliation":[{"name":"University Hospital Essen, University of Duisburg-Essen Department of Pediatrics II, , Essen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0092-5233","authenticated-orcid":false,"given":"Xiaofei","family":"Liu","sequence":"additional","affiliation":[{"name":"Institute for Biostatistics, Hannover Medical School , Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1544-9903","authenticated-orcid":false,"given":"Sebastian","family":"Voigt","sequence":"additional","affiliation":[{"name":"Institute for Virology, University Hospital Essen, University of Duisburg-Essen , Essen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carina","family":"Elsner","sequence":"additional","affiliation":[{"name":"Institute for Virology, University Hospital Essen, University of Duisburg-Essen , Essen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Schild","sequence":"additional","affiliation":[{"name":"University Hospital Hamburg-Eppendorf Department of Pediatric Nephrology, , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1846-675X","authenticated-orcid":false,"given":"Jun","family":"Oh","sequence":"additional","affiliation":[{"name":"University Hospital Hamburg-Eppendorf Department of Pediatric Nephrology, , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Taylan","sequence":"additional","affiliation":[{"name":"University Hospital of Cologne, Faculty of Medicine Department of Pediatric Nephrology, Children\u2019s and Adolescents\u2019 Hospital, , Cologne ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4116-598X","authenticated-orcid":false,"given":"Lutz T","family":"Weber","sequence":"additional","affiliation":[{"name":"University Hospital of Cologne, Faculty of Medicine Department of Pediatric Nephrology, Children\u2019s and Adolescents\u2019 Hospital, , Cologne ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4865-4906","authenticated-orcid":false,"given":"Nele K","family":"Kanzelmeyer","sequence":"additional","affiliation":[{"name":"Liver and Metabolic Diseases, Hannover Medical School Department of Pediatric Kidney, , Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0440-3053","authenticated-orcid":false,"given":"Gregor","family":"Bond","sequence":"additional","affiliation":[{"name":"Medical University of Vienna Division of Nephrology and Dialysis, Department of Medicine III, , Vienna ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5428-5687","authenticated-orcid":false,"given":"Stefanie","family":"Jeruschke","sequence":"additional","affiliation":[{"name":"University Hospital Essen, University of 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