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Pretransplantation Donor–Recipient Pair Seroreactivity Against BK Polyomavirus Predicts Viremia and Nephropathy After Kidney Transplantation
Author(s) -
Wunderink H. F.,
Meijden E.,
Blijde Brouwer C. S.,
Mallat M. J. K.,
Haasnoot G. W.,
Zwet E. W.,
Claas E. C. J.,
Fijter J. W.,
Kroes A. C. M.,
Arnold F.,
Touzé A.,
Claas F. H. J.,
Rotmans J. I.,
Feltkamp M. C. W.
Publication year - 2017
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.13880
Subject(s) - viremia , medicine , kidney transplantation , bk virus , immunology , serology , transplantation , viral load , polyomavirus infections , virology , antibody , virus
Kidney transplant donors are not currently implicated in predicting BK polyomavirus ( BKPyV ) infection in kidney transplant recipients. It has been postulated, however, that BKPyV infection originates from the kidney allograft. Because BKPyV seroreactivity correlates with BKPyV replication and thus might mirror the infectious load, we investigated whether BKPyV seroreactivity of the donor predicts viremia and BKPyV ‐associated nephropathy ( BKP y VAN ) in the recipient. In a retrospective cohort of 407 living kidney donor–recipient pairs, pretransplantation donor and recipient sera were tested for BKPyV IgG levels and correlated with the occurrence of recipient BKPyV viremia and BKP y VAN within 1 year after transplantation. Donor BKPyV IgG level was strongly associated with BKPyV viremia and BKP y VAN (p < 0.001), whereas recipient BKPyV seroreactivity showed a nonsignificant inverse trend. Pairing of high– BKPyV ‐seroreactive donors with low‐seroreactive recipients resulted in a 10‐fold increased risk of BKPyV viremia (hazard ratio 10.1, 95% CI 3.5–29.0, p < 0.001). In multivariate analysis, donor BKPyV seroreactivity was the strongest pretransplantation factor associated with viremia (p < 0.001) and BKP y VAN (p = 0.007). The proportional relationship between donor BKPyV seroreactivity and recipient infection suggests that donor BKPyV seroreactivity reflects the infectious load of the kidney allograft and calls for the use of pretransplantation BKPyV serological testing of (potential) donors and recipients.