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Impact of donor BK polyomavirus replication on recipient infections in living donor transplantation
Author(s) -
Grellier Jimmy,
Hirsch Hans H.,
Mengelle Catherine,
Esposito Laure,
Hebral Anne Laure,
Bellière Julie,
Weissbach Fabian,
Izopet Jacques,
Del Bello Arnaud,
Kamar Nassim
Publication year - 2018
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12917
Subject(s) - medicine , transplantation , kidney transplantation , viremia , polyomavirus infections , bk virus , urinary system , immunology , virology , antibody
Abstract Background Multiple risk factors for BK polyomavirus (BKPyV) replication after kidney transplantation have been described. Here, we investigated the impact of living donors’ urinary BKPyV shedding and recipients’ BKPyV antibody status pre‐transplant on BKPyV replication during the first year post‐transplantation. Methods We assessed a cohort of living kidney donors and their paired recipients (n = 121). All donors were tested before transplantation, and recipients were tested before and after transplantation for BKPyV viruria and viremia. BKPyV‐specific serology was assessed in all recipients at transplantation. Results Ten of 121 donors (8.3%) had urinary BKPyV shedding pre‐transplant, none had viremia. Overall, 33 (27.3%) recipients developed viruria after transplantation: 7 had received a kidney from a donor with BK viruria (7/10 positive donors) and 26 had received a kidney from a donor without BK viruria (26/111 negative donors; P = .0015). Fifteen (12.4%) recipients developed BK viremia after transplantation: 3 received a kidney from a donor with viruria (3/10 positive donors, 30%) and 12 received a kidney from a donor without viruria (12/111 negative donors, 11%; P = .08). One patient developed proven nephropathy. Ninety‐one percent of recipients were seropositive for BKPyV. No relationship between recipients’ sero‐reactivity at transplantation and post‐transplant BKPyV replication was observed. Pre‐transplant donor urinary shedding was an independent risk factor for post‐transplant BKPyV replication. Conclusion Screening living kidney donors for BKPyV can identify recipients at higher risk for BKPyV replication after transplantation who may benefit from intensified post‐transplant screening and treatment strategies.