Preemptive reduction of immunosuppression upon high urinary polyomavirus loads improves patient survival without affecting kidney graft function

et al. 2020

Virol J

Background BK virus allograft nephropathy is a serious complication after kidney transplantation, and the effect of pre-emptive intervention for high-level BK viruria has been verified, but protocols after kidney transplantation for early identification of high-level viruria are lacking. Methods This was a single-center study. The clinical data of the kidney transplant recipients and their donors in our center from January 1, 2015 to December 31, 2018, were collected. The patients were divided into the high-level BK viruria group (Group A) and a non-high-level BK viruria group (Group B) according to the qPCR results of BK virus DNA loads in urine samples. Significant variables were screened out by univariate analysis, and then the results were incorporated into a multivariate logistic regression model to analyze the independent risk factors for high-level BK viruria. Results A total of 262 recipients were included in the study. The incidence of high-level BK viruria was 13.4% (n = 35), and the median time of detection was 181 (range 91–1119) days. Univariate analysis showed that donor type ($$\chi^{2}$$ χ 2 = 21.770, P < 0.001), history of ATG/ATG-F application ($$\chi^{2}$$ χ 2 = 4.543, P = 0.033), acute rejection (AR) ($$\chi^{2}$$ χ 2 = 8.313, P = 0.004) and delayed graft function (DGF) ($$\chi^{2}$$ χ 2 = 21.170, P < 0.001) were related to high-level BK viruria. After the inclusion of the multivariate logistic regression model, the results showed deceased brain and cardiac donors (P = 0.032, OR = 3.927, 95% CI 1.122–13.746), AR (P = 0.022, OR = 4.709, 95% CI 1.253–17.697) and DGF (P = 0.001, OR = 6.682, 95% CI 2.288–19.518). Conclusions Donation by deceased brain and cardiac patients, history of AR and DGF were independent risk factors for high-level BK viruria after kidney transplantation.

Section: Introductionmentioning

confidence: 99%

Incidence and risk factors for high-level BK viruria: a single center study in China

et al. 2020

Virol J

“…The importance of prevention is underscored by the lack of a speci c treatment regimen for BKVAN. In 2013, the American Society of Transplantation [1] recommended starting intervention at the high-level BK viremia stage, but in a few studies, preemptive treatment of patients with BK viruria seemed to be more advantageous [2][3][4] . Early identi cation of high-risk patients plays an important role in prevention.…”

Section: Introductionmentioning

confidence: 99%

Incidence and Risk Factors for High-level BK viruria -A Single Center Study in China

et al. 2020

Preprint

Background BK virus allograft nephropathy (BKVAN) is a serious complication after kidney transplantation, and the effect of pre-emptive intervention for high-level BK viruria has been verified, but protocols after kidney transplantation for early identification of high-level viruria are lacking.Methods This was a single-center study. The clinical data of the kidney transplant recipients and their donors in our center from January 1, 2015 to December 31, 2018, were collected. The patients were divided into the high-level BK viruria group (Group A) and a non-high-level BK viruria group (Group B) according to the qPCR results of BK virus DNA loads in urine samples. Significant variables were screened out by univariate analysis, and then the results were incorporated into a multivariate logistic regression model to analyze the independent risk factors for high-level BK viruria.Results A total of 262 recipients were included in the study. The incidence of high-level BK viruria was 13.4% (n=35), and the median time of detection was 181 (range 91~1119) days. Univariate analysis showed that donor type ( =21.770, P < 0.001), history of ATG/ATG-F application ( =4.543, P=0.033), acute rejection (AR) ( =8.313, P=0.004) and delayed graft function (DGF) ( =21.170, P < 0.001) were related to high-level BK viruria. After the inclusion of the multivariate logistic regression model, the results showed deceased brain and cardiac donors (P=0.032, OR=3.927, 95% CI: 1.122~13.746), AR (P=0.022, OR=4.709, 95% CI: 1.253~17.697) and DGF (P=0.001, OR=6.682, 95% CI: 2.288~19.518).Conclusions Donation by deceased brain and cardiac patients, history of AR and DGF were independent risk factors for high-level BK viruria after kidney transplantation.

“…The importance of prevention is underscored by the lack of a specific treatment regimen for BKVAN. In 2013, American Society of Transplantation [1] recommended starting intervention at the stage of highlevel BK Viremia, but in a few studies, pre-emptive treatment with BK Viruria seemed to be more advantageous [2][3][4] . Early identification of high-risk patients plays an important role in prevention.…”

Section: Introductionmentioning

confidence: 99%

Incidence and Risk Factors for High-level BK Viruria -A Single Center Study in China

et al. 2020

Preprint

Background BK Virus Allograft Nephropathy (BKVAN) is a serious complication after kidney transplantation, and the effect of pre-emptive intervention for high-level BK viruria has been verified, but the protocols after kidney transplantation for early identification of high-level viruria is lacking.Methods This was a single-center respectively study. The clinical data of the kidney transplant recipients and their donors in our center from January 1, 2015 to December 31, 2018 were collected. According to the qPCR results of BK virus DNA loads in urine samples, the patients were divided into high-level BK Viruria Group (Group A) and none high-level BK Viruria Group (Group B). Significant variables were screened out by univariate analysis, and then the results were incorporated into multivariate logistic regression model to analyze the independent risk factors of high-level BK viruria.Results A total of 262 recipients were included in the study. The incidence of high-level BK viruria was 13.4% (n=35), and the median time of detection was 181(range 91~1119) days. Univariate analysis showed that the donor type ( =21.770, P < 0.001), history of ATG/ATG-F application ( =4.543, P=0.033), Acute Rejection (AR) ( =8.313, P=0.004) and Delayed Graft Function (DGF) ( =21.170, P < 0.001) were related with high-level BK viruria. After the inclusion of multivariate logistic regression model, the results showed that brain and cardiac deceased donors (P=0.032,OR=3.927, 95%CI:1.122~13.746), AR (P=0.022,OR=4.709, 95%CI:1.253~17.697) and DGF (P=0.001,OR=6.682, 95%CI:2.288~19.518).Conclusions Donation of Brain and Cardiac Deceased, history of AR, DGF were independent risk factors for high-level BK viruria after kidney transplantation.