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HLA Mismatching Increases the Risk of BK Virus Nephropathy in Renal Transplant Recipients
Author(s) -
Awadalla Yehia,
Randhawa Parmjeet,
Ruppert Kris,
Zeevi Adriana,
Duquesnoy Rene J.
Publication year - 2004
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/j.1600-6143.2004.00563.x
Subject(s) - medicine , bk virus , renal transplant , human leukocyte antigen , nephropathy , immunology , kidney transplantation , urology , virology , transplantation , diabetes mellitus , endocrinology , antigen
BK virus (BKV)nephropathy is a serious complication in kidney transplant recipients that may lead to irreversible graft failure. We have analyzed the degree of donor/recipient HLA compatibility and HLA antigen association in 40 kidney transplant patients with BKV nephropathy in comparison with a control group of 404 unaffected transplant recipients who were on tacrolimus‐based immunosuppression with no induction. HLA compatibility was assessed by determining the number of HLA‐A, ‐B, ‐DR‐mismatched antigens. BK virus nephropathy was diagnosed histologically and confirmed by immunochemistry. Univariate and multiple logistic regression statistical analyses have shown a significant association between BKV nephropathy and HLA mismatching. This analysis showed also that BKV nephritis is associated with a greater number of rejection episodes and a higher incidence of steroid‐resistant rejection requiring antilymphocyte treatment. There was no association between BKV nephropathy and any specific HLA allele. We propose that HLA mismatching promotes the development of BKV nephropathy through rejection‐related inflammatory processes and heavy immunosuppression which cause virus reactivation and injury of the tubular epithelium.