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Pretransplant serologic testing to identify the risk of polyoma BK viremia in pediatric kidney transplant recipients
Author(s) -
Ali Abdalla M.,
Gibson Ian W.,
Birk Patricia,
BlydtHansen Tom D.
Publication year - 2011
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2011.01583.x
Subject(s) - medicine , viremia , serology , immunology , kidney transplant , kidney transplantation , kidney , virology , human immunodeficiency virus (hiv) , antibody
Ali AM, Gibson IW, Birk P, Blydt‐Hansen TD. Pretransplant serologic testing to identify the risk of polyoma BK viremia in pediatric kidney transplant recipients.
Pediatr Transplantation 2011: 15:827–834. © 2011 John Wiley & Sons A/S. Abstract: This study investigated the age‐related prevalence of a prior polyoma BKV infection at the time of transplantation and association with subsequent development of BKV viremia. We measured BKV‐specific antibody titers in stored serum samples obtained before transplantation in 94 pediatric kidney transplant recipients (in a single‐center, retrospective analysis) and 40 matched donors from 1986 to 2007. Titers were categorized as LOW or HIGH serostatus at titers of ≤1:2560 and ≥1:10 240, respectively. Of these, 36 recipients transplanted since 2002 were prospectively screened for BKV viremia. Seventeen percent of recipients aged 0–6 yr had HIGH BKV serostatus compared with 73% of older recipients (p < 0.002). The prevalence of HIGH donor BKV serostatus was 73%. Five prospectively screened patients (14%) developed early BKV viremia, and an additional 4 (11%) had late onset of BKV viremia. There were three cases (8%) of BKVAN. LOW BKV serostatus was significantly associated with early BKV viremia (p = 0.02). Donor HIGH to recipient LOW (HIGH/LOW) had the highest risk of BKV viremia (4/7; 57%), compared with LOW/LOW (0/3; 0%) and recipient HIGH (1/26; 4%) (p = 0.004). BKV IgG titers are low in young pediatric kidney transplant recipients, and LOW BKV serostatus is associated with an increased risk of early BKV infection post‐transplant, particularly in the context of donor with HIGH BKV serostatus.