BK Virus Replication and Nephropathy After Alemtuzumab-Induced Kidney Transplantation

Authors

  • N. Theodoropoulos,

    1. Division of Infectious Diseases, The Ohio State University College of Medicine, Columbus, OH†
    2. Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL
    3. Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University, Chicago, IL
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    • Research performed while Dr. Theodoropoulos was at Northwestern University; author is now at Ohio State University.

  • E. Wang,

    1. Division of Organ Transplantation and
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  • S. Penugonda,

    1. Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL
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  • D. P. Ladner,

    1. Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University, Chicago, IL
    2. Division of Organ Transplantation and
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  • V. Stosor,

    1. Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL
    2. Division of Organ Transplantation and
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  • J. Leventhal,

    1. Division of Organ Transplantation and
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  • J. Friedewald,

    1. Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University, Chicago, IL
    2. Division of Nephrology, Northwestern University Feinberg School of Medicine, Chicago, IL
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  • M. P. Angarone,

    1. Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL
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  • M. G. Ison

    Corresponding author
    1. Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL
    2. Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University, Chicago, IL
    3. Division of Organ Transplantation and
    • Division of Infectious Diseases, The Ohio State University College of Medicine, Columbus, OH†
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  • The study was presented in part at the American Transplant Congress 2011, Philadelphia, Pennsylvania, USA.

Corresponding author: Michael. G. Ison, mgison@northwestern.edu

Abstract

BK virus nephropathy (BKVN) is a recognized cause of graft failure in kidney transplant recipients. There are limited data on the epidemiology of BK virus (BKV) infection after alemtuzumab induction. By clinical protocol, the kidney transplant recipients at our center were screened with BKV plasma PCR monthly for the first 4 months posttransplant then every 2–3 months for 2 years. A single center retrospective cohort study of all kidney transplant recipients from January 2008 to August 2010 was conducted to determine incidence and outcomes of BKV infection. Descriptive statistics and Kaplan–Meier analysis was performed. Of 666 recipients, 250 (37.5%) developed viruria, 80 (12%) developed viremia and 31 (4.7%) developed BKVN at a median of 17, 21 and 30 weeks, respectively. Induction with alemtuzumab did not significantly affect incidence of BKVN. Increased recipient age, African American race, acute graft rejection and CMV infection were significantly associated with the development of BKVN in multivariate analysis. The incidence of BK viruria, viremia and nephropathy was not significantly different among kidney transplant recipients who received alemtuzumab induction compared to patients receiving less potent induction.

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