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Diagnostic test for HHV8 exposure

Valeria Rossetti, MD

Letizia Corinna Morlacchi, MD

Solid organ transplant candidates will undergo serological screening for HHV8 at time of listing and transplantation.

In the event of a recipient/donor mismatch R-/D+ or in the presence of a seropositive recipient (R+), blood levels of HHV8 DNA will be monitored together with specific IGRA for HHV8.

Patients on the waiting list for solid organ transplantation will undergo serological screening for HHV8 (lytic and latent antigens) in the pre-transplant phase, both at time of listing and then at the time of transplantation; if seropositivity is found, further investigations will be performed, i.e. blood levels of HHV8 DNA and specific Elispot for HHV8.

As for donors, serological testing for HHV8 (lytic and latent antigens) will be performed.

AFTER SOLID ORGAN TRANSPLANTATION

* Patients found HHV8 seropositive in the pretransplant phase (R +), being at risk of HHV8 reactivation, will be monitored monthly in terms of viremia (HHV8 DNA) and specific IGRA for HHV8 for the first 6 months after transplantation and subsequently every 3 months up to 12 months post transplant.
* In case of patients who were found HHV8 seronegative at time of transplantation, donor serology will be evaluated. In case of R-/D+ mismatch, SOT recipients will receive the same monitoring of R + patients (blood levels of HHV8 DNA and specific IGRA for HHV8 monthly for the first 6 months and then every 3 months up to 12 months after transplantation).
* With reference to lung transplant patients, in cases of R + or R- / D +, HHV8 DNA will also be searched on the BAL obtained during surveillance bronchoscopies (usually at 3, 6 and 12 months after transplantation).

HHV8 and Solid Organ Transplantation

Screening for HHV8 Infection in Solid Organ Transplantation Donors, Candidates and Recipients

Incidence of HHV8 seropositivity among solid organ transplantations donors, candidates and recipients

Incidence of HHV8 mismatch between solid organ transplantations donors and recipients

Incidence of HHV8 related disease after solid organ transplantation

Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico

T lymphocytes population description through blood, urine and faeces samples

Immune cells population assesment

Cancer is a well known complication about long term transplantation. Cancer outcomes are due to the immunosuppressive treatment that prevents transplanted people from rejection. By lowering the effectiveness of the immune system, immune cells are no longer able to seek and destroy cancer cells.

The goal here is to study immunes cells population of people that were transplanted 10 years ago and are now treated either by a corticosteroid - azathioprine association, or only by cyclosporine A.

Immunosuppression's Long Term Impact on Anti-tumoral Oversight in Kidney Transplantation

Study 2 types of T lymphocytes (by flow cytometry) that are suspected to be responsible of the graft non rejection and the cancer outcome, treated by corticosteroid - azathioprine association or cyclosporine A

Study the modification of the intestinal bacteria population that might led to an "operational tolerance", depending on the immunosuppressive treatment : the DNA will be extracted from the faeces and a typing will be carried out by Polymerase Chain Reaction

Assess cancer incidence, on a population of people with kidney transplantation (since 10 years) : observation of adverse events during visits

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
HHV8 and Solid Organ Transplantation	NCT05081141	HHV8 HHV8 Infection HHV8-Related Ma... Kaposi Sarcoma Lung Transplant... Liver Transplan... Kidney Transpla... Castleman Disea...	Diagnostic test...	18 Years -	Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico
Immunosuppression's Long Term Impact on Anti-tumoral Oversight in Kidney Transplantation	NCT03227965	Kidney Transpla...	Immune cells po...	18 Years -	Poitiers University Hospital

Spots Global Cancer Trial Database for kidney transplant; complications