Risk Factors for the Development of BK Virus Nephropathy in Renal Transplant Recipients

Abstract The BK polyoma virus has, in recent years, become a significant cause of renal allograft dysfunction and failure. Among 260 adult kidney transplant recipients, those with biopsy-proven BK virus nephropathy (BKVN) were compared with those without BKVN with regard to gender, age, race, reject...

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Bibliographic Details
Published in:Transplantation proceedings 2015-10, Vol.47 (8), p.2465-2469
Main Authors: Pai, D, Mann, D.M, Malik, A, Hoover, D.R, Fyfe, B, Mann, R.A
Format: Article
Language:English
Subjects:
Adult
Antilymphocyte Serum - therapeutic use
Biopsy
BK Virus
Female
Humans
Immunosuppression - adverse effects
Kidney Diseases - virology
Kidney Transplantation - adverse effects
Male
Middle Aged
Polyomavirus Infections - etiology
Risk Factors
Surgery
Transplant Recipients
Transplantation, Homologous - adverse effects
Tumor Virus Infections - etiology
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Summary:Abstract The BK polyoma virus has, in recent years, become a significant cause of renal allograft dysfunction and failure. Among 260 adult kidney transplant recipients, those with biopsy-proven BK virus nephropathy (BKVN) were compared with those without BKVN with regard to gender, age, race, rejection episodes, time on dialysis, number of organs transplanted, HLA match, live donor versus deceased donor, cold ischemia time, delayed graft function, cytomegalovirus (CMV) serostatus of donor and recipient, induction therapy, and maintenance immunosuppression. Episodes of rejection (35.7% of patients with BKVN vs 8.5% of patients without BKVN; P  = .01), transplantation of >1 organ (35.7% of patients with BKVN vs 9.0% of patients without BKVN; P  = .01), positive CMV serology in both donor and recipient (71.4% of patients with BKVN vs 41.1% of patients without BKVN; P  = .03), and a greater cumulative dose of daclizumab use at the time of induction (2.24 ± 0.05 mg/kg in patients with BKVN vs 2.03 ± 0.14 mg/kg in patients without BKVN; P  = .04) were statistically significant risk factors for the development of BKVN. Those who developed BKVN received a higher mean cumulative dose of rabbit antithymoglobulin for induction therapy, but that difference failed to achieve statistical significance ( P  = .07).
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2015.08.006