High torque Teno virus load is associated with increased all-cause mortality risk in liver transplant recipients: a...

Liver transplant recipients have twice the cancer risk than the general population, and de novo cancer is a leading cause of mortality after transplantation. Torque Teno Virus (TTV) is a potential marker of immune function. However, its association with long-term outcomes such as all-cause mortality and de novo cancer remains unexplored. In this Scandinavian multicenter cohort biobank study, plasma samples collected one year after transplantation were analyzed for TTV load to investigate its association with (1) all-cause mortality, (2) any de novo cancer, (3) de novo cancer excluding non-melanoma skin cancer (NMSC), and (4) NMSC using Cox regression analyses. Survival curves were plotted using Kaplan-Meier analysis. We analyzed the data of 625 liver transplant recipients. During a median follow-up of four years, 83 (13 %) recipients developed cancer (105 cancers). Of these, 39 were de novo cancers, excluding NMSC, and 66 were NMSCs. Overall, 47 recipients (8 %) died (all-cause mortality). Recipients with a high versus a low TTV load had an increased risk of all-cause mortality in the adjusted model (aHR, 5.31 [95 %CI 1.05-26.83]). The 5-year survival rates were 81 % and 100 % in the high- and low-TTV groups, respectively (p = 0.004). TTV load was not significantly associated with any de novo cancer or de novo cancer, excluding NMSC and NMSC. A high TTV load was associated with an increased risk of all-cause mortality in liver transplant recipients. With further validation, the TTV load can potentially serve as a risk stratification tool.