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      Characteristics of HAM/TSP after kidney transplantation from HTLV-1 positive living donors

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      1 , , 2 , 3 , 4 , 4 , 4 , 1 , 1 , 5 , 6 , 2 , 4
      Retrovirology
      BioMed Central
      17th International Conference on Human Retroviruses: HTLV and Related Viruses
      18-21 June 2015

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          Abstract

          It has been sporadically reported that HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) develops after living-donor kidney transplantation from HTLV-1 positive donors (D+) to negative recipients (R-). However, these details have been unknown. Thus we evaluated the incidence and clinical characteristics of HAM/TSP after living-donor kidney transplantation from D+ to R-(D+R-transplantation). Using data obtained from the Japanese Renal Transplant Registry, we analyzed 13,299 cases of living-donor kidney transplantation between 2000 and 2013 in Japan. In addition, we have collected information about 5 patients who developed HAM/TSP after D+R-transplantation. The incidence of HAM/TSP after D+R-transplantation was calculated as the ratio of “the number of recipients who developed HAM/TSP” to “the number of cases of D+R-transplantation”. The characteristics of HAM/TSP in D+R-transplant recipients such as time from transplantation to disease onset and rate of disease progression are investigated. About 70% of all 13,299 donors took a HTLV-1 antibody test and 64 cases were positive for HTLV-1 antibody. Although the remaining 4,072 donors didn't take the antibody test, we estimated the number of HTLV-1 positive donors as 36 according to the HTLV-1 prevalence in Japan. As a result, the estimated incidence of HAM/TSP after D+R-transplantation was 5%. All the 5 cases of HAM/TSP after D+R-transplantation showed an early onset after transplantation. Four out of five cases developed rapidly and had difficulty walking in one or two years. This study demonstrated that incidence rate (5%) of HAM/TSP in recipients after D+R-transplantation is extremely higher compared to the lifetime risk (0.25%) of HAM/TSP in an HTLV-1-infected person. Further, this study suggested that HAM/TSP after D+R-transplantation is characterized by rapid onset and progression. Therefore, we need to conduct nationwide survey to assess the risk of D+R-transplantation.

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          Author and article information

          Contributors
          Conference
          Retrovirology
          Retrovirology
          Retrovirology
          BioMed Central
          1742-4690
          2015
          28 August 2015
          : 12
          : Suppl 1
          : O14
          Affiliations
          [1 ]St. Marianna University School of Medicine, Kawasaki, Kanagawa, 2168511, Japan
          [2 ]Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Kawasaki, Kanagawa, 2168511, Japan
          [3 ]Taisho Hospital, Kagoshima, Kagoshima, 8900067, Japan
          [4 ]Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki, Kanagawa, 2168511, Japan
          [5 ]Department of Neurology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, 2168511, Japan
          [6 ]Department of Urology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, 2168511, Japan
          Article
          1742-4690-12-S1-O14
          10.1186/1742-4690-12-S1-O14
          4577778
          a73c4783-9c7d-462b-9a1b-b5bfb492f743
          Copyright © 2015 Kimura et al.

          This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

          17th International Conference on Human Retroviruses: HTLV and Related Viruses
          Trois Ilets, Martinique
          18-21 June 2015
          History
          Categories
          Oral Presentation

          Microbiology & Virology
          Microbiology & Virology

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