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The impact of recipient BKV shedding before transplant on BKV viruria, DNAemia, and nephropathy post‐transplant: A prospective study
Author(s) -
Verghese P. S.,
Schmeling D. O.,
Filtz E. A.,
Matas A. J.,
Balfour H. H.
Publication year - 2017
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/petr.12942
Subject(s) - medicine , viremia , nephropathy , immunosuppression , polyomavirus infections , kidney transplantation , gastroenterology , immunology , bk virus , transplantation , virus , endocrinology , diabetes mellitus
We previously demonstrated that detectable BKV replication in donor urine pretransplant was significantly associated with post‐transplant recipient BKV viremia. In this 4‐year prospective study, we assessed whether recipient BKV replication pretransplant was associated with post‐transplant viremia/BKV nephropathy. We studied 220 primary adult and pediatric organ transplant recipients for 490 person‐years and 2100 clinical visits. BKV viruria was detectable in 28 (16%), 26 adults and two children; and viremia in none pretransplant. Post‐transplant viruria occurred in all recipients with pretransplant BKV viruria, significantly more than in recipients without pretransplant viruria on univariate ( P <.005) and multivariate analysis including type of organ transplanted and immunosuppression type ( P .008). Time to post‐transplant viruria was significantly shorter in recipients with pretransplant viruria ( P .01). By univariate and multivariate analysis, BKV viruria in recipients pretransplant did not impact post‐transplant BKV viremia ( P =.97 and .97, respectively) even when stratified by type of organ transplant (kidney P =.6; liver P =.5). The peak serum and urine BKV PCR post‐transplant were not significantly different in patients with pretransplant BKV viruria and no one developed BK nephropathy. In conclusion, recipient BKV viruria prior to transplant predicts post‐transplant viruria but not viremia or BKV nephropathy.