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Isolated heart and liver transplant recipients are at low risk for polyomavirus BKV nephropathy
Author(s) -
Puliyanda Dechu P.,
Amet Nurmamet,
Dhawan Archana,
Hilo Lara,
Radha Raju K.,
Bunnapradist Suphamai,
Czer Lawrence,
Martin Paul,
Jordan Stanley,
Toyoda Mieko
Publication year - 2006
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/j.1399-0012.2005.00480.x
Subject(s) - nephropathy , medicine , immunosuppression , viremia , kidney , polyomavirus infections , bk virus , kidney disease , kidney transplantation , immunology , gastroenterology , endocrinology , virus , diabetes mellitus
Background: BKV infection and nephropathy is a significant cause of allograft dysfunction in kidney transplantation. BKV viremia, rather than viruria, corresponds to BKV nephropathy. The prevalence of BKV viremia in non‐renal solid organ transplants has not been systematically evaluated. Methods: We determined prevalence of BKV viremia in kidney, combined kidney–heart, kidney–liver, kidney–pancreas, kidney–heart–liver, and heart and liver transplant recipients using BKV‐PCR. Results: Seven out of 173 (4%) kidney transplant recipients had BKV viremia, with BKV>2 × 10 5 copies/mL in 6/7 and 1.9 × 10 3 in the remaining one patient. BKV viremia was not found in 24 heart transplant recipients, whereas 1/37 (2.7%) liver transplants showed low copy numbers (≤10 3 ). BKV‐PCR≤10 3 copies/mL were also found in one of each combined kidney–heart and kidney–liver transplant recipients. BKV nephropathy was proven by biopsy in 4/6 patients with high BKV viral loads. All six patients showed renal dysfunction, requiring reduction in immunosuppression and antiviral therapy. All four patients with low BKV viral loads (1.9 × 10 3 or ≤10 3 ) showed stable renal function after reduction of immunosuppression or no treatment, respectively. Conclusion: Higher BKV levels in plasma are associated with renal dysfunction. Kidney transplant recipients are at high risk compared with recipients of isolated heart or liver allografts, for development of BKV nephropathy.