Premium
BK viremia surveillance and outcomes in simultaneous pancreas‐kidney transplant recipients
Author(s) -
Westphal Scott G.,
Lyden Elizabeth R.,
Langewisch Eric D.,
Miles Clifford D.
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13010
Subject(s) - medicine , immunosuppression , bk virus , polyomavirus infections , viremia , asymptomatic , pancreas transplantation , kidney , urology , kidney transplantation , gastroenterology , surgery , immunology , virus
Background While screening for asymptomatic BK viremia ( BKV ) has been well studied in isolated kidney transplant recipients, there is a paucity of published outcomes in simultaneous pancreas‐kidney ( SPK ) transplant recipients who underwent BKV screening followed by pre‐emptive reduction in immunosuppression. Methods This is a single‐center, retrospective review of 31 consecutive SPK recipients who were transplanted over a 5‐year period following the initiation of a serum BKV screening protocol. Results BK viremia developed in 11 (35.5%) patients, and all patients achieved complete viral clearance following reduction in immunosuppression. Two patients (6.5%) developed BK virus nephropathy, but both had preserved allograft function. One patient developed mild rejection of the kidney allograft following clearance of BKV , and two patients developed mild rejection of the pancreas allograft after reduction in immunosuppression, but there were no kidney or pancreas allograft losses due to rejection. The development of BK viremia did not impact overall patient survival or kidney and pancreas allograft survival. Conclusion Screening asymptomatic SPK recipients for BKV followed by reduction in maintenance immunosuppression appears to be an effective strategy to prevent kidney allograft dysfunction and graft loss due to BK virus nephropathy, without compromising pancreas allograft outcomes.