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Prevalence and risk factors of polyomavirus BK replication in simultaneous pancreas/kidney transplant recipients from a single transplant center

Authors


  • Conflict of interest: None.

Corresponding author: Petr Boucek, MD, Diabetes Center, Institute for Clinical and Experimental Medicine, Videnska 9, 14021 Prague 4, Czech Republic.
Tel.: +420 261363158; fax: +420 261362820;
e-mail: petr.boucek@ikem.cz

Abstract

Mindlova M, Boucek P, Saudek F, Skibova J, Jedinakova T, Lipar K, Adamec M, Hirsch HH. Prevalence and risk factors of polyomavirus BK replication in simultaneous pancreas/kidney transplant recipients from a single transplant center.
Clin Transplant 2011 DOI: 10.1111/j.1399-0012.2011.01488.x.
© 2011 John Wiley & Sons A/S.

Abstract:  Background:  BK virus (BKV) replication is considered as a marker of risk for polyomavirus BK-associated nephropathy (PVAN). We evaluated the occurrence and risk factors for BKV DNA positivity following simultaneous pancreas/kidney transplantation (SPK).

Methods:  Point prevalence of BK viruria and viremia was assessed in 183 SPK recipients. Real-time polymerase chain reaction was used with a detection threshold of 103 copies/mL. High-level BKV positivity was defined as viruria and/or viremia >107 and >104 copies/mL, respectively. BKV-positive patients were retested after 4–13 months and underwent an additional six-month clinical follow-up.

Results:  Urine and serum BKV positivity was detected in 28 (17.3% of available samples) and 7 (3.8%) patients, with high-level viruria and viremia occurring in 6 (3.7%) and 3 (1.6%) patients, respectively. PVAN was biopsy-confirmed in 1 and suspected as a cause of progressive renal failure in another SPK recipient. Patients with single low-level viruria did not progress to high-level positivity or PVAN at follow-up. In multivariate analysis, pre-transplant diabetes duration and delayed graft function were independently associated with BKV positivity.

Conclusions:  Point prevalence of high-level BKV positivity and PVAN was low in SPK recipients from a single center. Diabetes duration and delayed graft function were independent risk factors for BKV replication.

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