Volume 9 Issue 1
Jan.  2018
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Fan Yu, Shi Bingyi, Qian Yeyong, et al. Clinical study on the effect of BK virus infection on renal allograft function after renal transplantation[J]. ORGAN TRANSPLANTATION, 2018, 9(1): 51-57. doi: 10.3969/j.issn.1674-7445.2018.01.007
Citation: Fan Yu, Shi Bingyi, Qian Yeyong, et al. Clinical study on the effect of BK virus infection on renal allograft function after renal transplantation[J]. ORGAN TRANSPLANTATION, 2018, 9(1): 51-57. doi: 10.3969/j.issn.1674-7445.2018.01.007

Clinical study on the effect of BK virus infection on renal allograft function after renal transplantation

doi: 10.3969/j.issn.1674-7445.2018.01.007
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  • Corresponding author: Shi Bingyi, Email: shibingyi@medmail.com.cn
  • Received Date: 2017-09-15
    Available Online: 2021-01-19
  • Publish Date: 2018-01-15
  •   Objective  To analyze the impairment of renal allograft function in renal transplant recipients caused by BK virus infection after renal transplantation.  Methods  Clinical data of 210 recipients who underwent allogenic renal transplantation and received BK virus monitoring regularly were analyzed retrospectively. The incidence of BK viruria, viremia and BK virus nephropathy (BKVN) after renal transplantation was summarized. The effect of BK virus infection on renal allograft function and prognosis of renal allograft function after the removement of BK virus were analyzed.  Results  Among the 210 recipients, there were 46 cases with pure viruria, 46 cases with viremia complicated with viruria and 7 cases with BKVN confirmed by pathological biopsy. The level of serum creatinine (Scr) in the recipients with viremia after renal transplantation was linearly related to BK viral load in urine and blood (r=0.594, 0.672, both P < 0.01). The level of Scr increased significantly when BK viral load in blood of the recipients with viremia was found positive for the first time, and increased continuously after viremia sustained. And the level of Scr decreased slightly when blood viral load turned to negative after treatment, but still significantly higher than before virus infection. All the above differences were statistically significant (all P < 0.05). Compared with the basic level, there was no significant difference in the level of Scr of recipients with pure viruria during positive viruria (all P>0.05).  Conclusions  It will impair the renal allograft function when BK viremia occurs after renal transplantation, and it is necessary to monitor viral infection regularly. Once the blood BK virus is found positive, it shall be implemented immediately to reduce the intensity of immunosuppression as the preferred clinical intervention.

     

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  • [1]
    HIRSCH HH, KNOWLES W, DICKENMANN M, et al. Prospective study of polyomavirus type BK replication and nephropathy in renal-transplant recipients[J]. N Engl J Med, 2002, 347(7): 488-496. DOI: 10.1056/NEJMoa020439.
    [2]
    HIRSCH HH, RANDHAWA P, AST Infectious Diseases Community of Practice. BK virus in solid organ transplant recipients[J]. Am J Transplant, 2009, 12(9): S136-S146. DOI: 10.1111/j.1600-6143.2009.02904.x.
    [3]
    GOLDBERG RJ, WENG FL, Kandula P. Acute and chronic allograft dysfunction in kidney transplant recipients[J]. Med Clin North Am, 2016, 100(3): 487-503. DOI: 10.1016/j.mcna.2016.01.002.
    [4]
    HAMMARIN AL, ÖQVIST B, WAHLGREN J, et al. Systematic screening of BK virus by real-time PCR prevents BK virus associated nephropathy in renal transplant recipients[J]. J Med Virol, 2011, 83(11): 1959-1965. DOI: 10.1002/jmv.22196.
    [5]
    HASAN MR, TAN R, AL-RAWAHI G, et al. Comparative evaluation of laboratory developed real-time PCR assays and RealStar(®) BKV PCR Kit for quantitative detection of BK polyomavirus[J]. J Virol Methods, 2016, 234: 80-86. DOI: 10.1016/j.jviromet.2016.04.009.
    [6]
    SAWINSKI D, Goral S. BK virus infection: an update on diagnosis and treatment[J]. Nephrol Dial Transplant, 2015, 30(2):209-217. DOI: 10.1093/ndt/gfu023.
    [7]
    WRIGHT AJ, GILL JS. Strategies to prevent BK virus infection in kidney transplant recipients[J]. Curr Opin Infect Dis, 2016, 29(4): 353-358. DOI: 10.1097/QCO.0000000000000278.
    [8]
    解俊杰, 石炳毅, 钱叶勇, 等.肾移植后BK病毒感染者实时荧光定量PCR检测[J].中国组织工程研究, 2012, 16(5): 797-800. DOI: 10.3969/j.issn.1673-8225.2012.05.009.

    XIE JJ, SHI BY, QIAN YY, et al. BK virus infection detected by real-time fluorescent quantitative PCR method after renal transplantation[J]. Chin J Tissue Eng Res, 2012, 16(5): 797-800. DOI: 10.3969/j.issn.1673-8225.2012.05.009.
    [9]
    JOHNSTON O, JASWAL D, GILL JS, et al. Treatment of polyomavirus infection in kidney transplant recipients: a systematic review[J]. Transplantation, 2010, 89(9): 1057-1070. DOI: 10.1097/TP.0b013e3181d0e15e.
    [10]
    GARDNER SD, FIELD AM, COLEMAN DV, et al. New human papovavirus (B.K.) isolated from urine after renal transplantation[J]. Lancet, 1971, 1(7712): 1253-1257. DOI: 10.1016/S0140-6736(71)90562-9.
    [11]
    PURIGHALLA R, SHAPIRO R, MCCAULEY J, et al. BK virus infection in a kidney allograft diagnosed by needle biopsy[J]. Am J Kidney Dis, 1995, 26(4): 671-673. DOI: 10.1016/0272-6386(95)90608-8.
    [12]
    RANDHAWA PS, FINKELSTEIN S, SCANTLEBURY V, et al. Human polyoma virus-associated interstitial nephritis in the allograft kidney[J]. Transplantation, 1999, 67(67):103-109. DOI: 10.1097/00007890-199901150-00018.
    [13]
    DHARNIDHARKA VR, CHERIKH WS, ABBOTT KC. An OPTN analysis of national registry data on treatment of BK virus allograft nephropathy in the United States[J]. Transplantation, 2009, 87(7): 1019-1026. DOI: 10.1097/TP.0b013e31819cc383.
    [14]
    GIRMANOVA E, BRABCOVA I, BANDUR S, et al. A prospective longitudinal study of BK virus infection in 120 Czech renal transplant recipients[J]. J Med Virol, 2011, 83(8): 1395-1400. DOI: 10.1002/jmv.22106.
    [15]
    SCHWARZ A, LINNENWEBER-HELD S, HEIM A, et al. Viral origin, clinical course, and renal outcomes in patients with BK virus infection after living-donor renal transplantation[J]. Transplantation, 2016, 100(4): 844-853. DOI: 10.1097/TP.0000000000001066.
    [16]
    HIRSCH HH. BK virus: opportunity makes a pathogen[J]. Clin Infect Dis, 2005, 41(3): 354-360. DOI: 10.1086/431488.
    [17]
    HARIHARAN S. BK virus nephritis after renal transplantation[J]. Kidney Int, 2006, 69(4): 655-662. DOI: 10.1038/sj.ki.5000040.
    [18]
    HIRSCH HH, STEIGER J. Polyomavirus BK[J]. Lancet Infect Dis, 2003, 3(10): 611-623. DOI: 10.1016/S1473-3099(03)00770-9.
    [19]
    JAMBOTI JS, BK virus nephropathy in renal transplant recipients[J]. Nephrology (Carlton), 2016, 21(8): 647-654. DOI: 10.1111/nep.12728.
    [20]
    GINEVRI F, DE SANTIS R, COMOLI P, et al. Polyomavirus BK infection in pediatric kidney-allograft recipients: a single-center analysis of incidence, risk factors, and novel therapeutic approaches[J]. Transplantation, 2003, 75(8): 1266-1270. DOI: 10.1097/01.TP.0000061767.32870.72.
    [21]
    MASUTANI, K, SHAPIRO R, BASU A, et al. The Banff 2009 working proposal for polyomavirus nephropathy: a critical evaluation of its utility as a determinant of clinical outcome[J]. Am J Transplant, 2012, 12(4): 907-918. DOI: 10.1111/j.1600-6143.2012.03993.x.
    [22]
    NICKELEIT V, KLIMKAIT T, BINET IF, et al. Testing for polyomavirus type BK DNA in plasma to identify renal-allograft recipients with viral nephropathy[J]. N Engl J Med, 2000, 342(18): 1309-1315. DOI: 10.1056/NEJM200005043421802.
    [23]
    EL ANSARY M, ABD ELHAMID S, SAADI G, et al. Prevalence of polyoma BK virus infection among living-donor renal transplant recipients[J]. Transpl Infect Dis, 2016, 18(4): 529-537. DOI: 10.1111/tid.12557.
    [24]
    SAWINSKI D, FORDE KA, TROFE-CLARK J, et al. Persistent BK viremia does not increase intermediate-term graft loss but is associated with de novo donor-specific antibodies[J]. J Am Soc Nephrol, 2015, 26(4): 966-975. DOI: 10.1681/ASN.2014010119.
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