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Clinical Trial
. 2017 Aug;21(5):10.1111/petr.12942.
doi: 10.1111/petr.12942. Epub 2017 May 29.

The impact of recipient BKV shedding before transplant on BKV viruria, DNAemia, and nephropathy post-transplant: A prospective study

P S Verghese  1 , D O Schmeling  2 , E A Filtz  2 , A J Matas  3 , H H Balfour Jr  1   2
Affiliations
Clinical Trial

The impact of recipient BKV shedding before transplant on BKV viruria, DNAemia, and nephropathy post-transplant: A prospective study

P S Verghese et al. Pediatr Transplant. 2017 Aug.

Abstract

We previously demonstrated that detectable BKV replication in donor urine pretransplant was significantly associated with post-transplant recipient BKV viremia. In this 4-year prospective study, we assessed whether recipient BKV replication pretransplant was associated with post-transplant viremia/BKV nephropathy. We studied 220 primary adult and pediatric organ transplant recipients for 490 person-years and 2100 clinical visits. BKV viruria was detectable in 28 (16%), 26 adults and two children; and viremia in none pretransplant. Post-transplant viruria occurred in all recipients with pretransplant BKV viruria, significantly more than in recipients without pretransplant viruria on univariate (P<.005) and multivariate analysis including type of organ transplanted and immunosuppression type (P .008). Time to post-transplant viruria was significantly shorter in recipients with pretransplant viruria (P .01). By univariate and multivariate analysis, BKV viruria in recipients pretransplant did not impact post-transplant BKV viremia (P=.97 and .97, respectively) even when stratified by type of organ transplant (kidney P=.6; liver P=.5). The peak serum and urine BKV PCR post-transplant were not significantly different in patients with pretransplant BKV viruria and no one developed BK nephropathy. In conclusion, recipient BKV viruria prior to transplant predicts post-transplant viruria but not viremia or BKV nephropathy.

Keywords: BK nephropathy; BK viruria; BK virus; virus.

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Conflict of interest statement

Disclosure

The authors of this manuscript have no conflicts of interest to disclose as described by Pediatric Transplantation.

Figures

FIGURE 1
FIGURE 1
Survival curves for BK viremia and BK viruria stratified by whether the recipients had detectable BK viruria prior to transplant
See this image and copyright information in PMC

Comment in

References

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