Steering of Transplant Immunosuppression by Virus-Specific T Cells: A Randomized Controlled Trial (Ivist Trial)

BK Polyomavirus Nephropathy in Kidney Transplantation: Balancing Rejection and Infection

“…Meanwhile, fewer acute rejection events, similar de novo donor-specific antibody development, viral infection (CMV, herpes simplex virus, Epstein-Barr virus (EBV)), and BKVN were noted in the intervention group [173]. This study provides a safe measurement other than the pharmacokinetic method for personalizing dosing and IS reduction.…”

“…A multicenter, randomized, controlled trial enrolled 64 pediatric KTRs. They monitored trough level in both groups and virusspecific T cell levels in the intervention group for IS dosage adjustment [173]. Compared to control groups, both everolimus and cyclosporine's dosage was reduced in the intervention group with no difference in renal function 2 years after transplantation.…”

“…Future larger trials focusing on prevention overimmunosuppression for adult transplant recipients with a standard triple regimen consisting of tacrolimus, mycophenolate mofetil, and steroid are expected. The IVIST trial may be a paradigm shift for immunoassay-guided optimal immunosuppression in future clinical practice [173] The therapeutic mechanisms of intravenous immunoglobulin (IVIG) for BKVN are not fully understood. Both donated and commercial IVIG contains IgG against various infectious diseases, including BKPyV neutralizing antibodies [174,175].…”