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Prevalence, Risk Factors, Treatment, and Overall Impact of BK Viremia on Kidney Transplantation.
Transplant Proc 2019 Jul - Aug; 51(6):1801-1809TP

Abstract

BK viremia (BKV) is a recognized and potentially serious problem in renal transplantation. The risk factors and the impact of BKV on renal allograft and patient survival are controversial. This study reports an 8-year, single-center experience on the prevalence, risk factors, and outcomes of BKV in kidney transplant recipients. This is a retrospective analysis of all patients who received a kidney transplant at the University of Kentucky and had BK viral titers available from 2009 to 2017. BKV was defined by a polymerase chain reaction viral load of ≥ 10,000 copies per mL. Demographic, clinical, and laboratory data generated during routine outpatient follow up and inpatients records were collected. Independent risk factors for BKV were determined using uni- and multivariate analysis. Graft and patient survival was compared using Kaplan-Meier analysis, and the severity of polyomavirus nephropathy on biopsy was scored using the Banff 2017 classification. We identified 122 BK positive (19%) and 527 BK negative (81%) patients. BKV developed after a median of 115 days (range, 80-249 days) following kidney transplantation. The 1-, 5-, and 10-year graft survival was 97%, 75%, and 33% in the BKV group and 96%, 85%, and 71% in the BK negative group, respectively. Likewise, the 1-, 5-, and 10-year patient survival was 98%, 84%, and 52% in the BKV group and 98%, 92%, and 84% in the BK negative group. Male sex, age at transplantation, maintenance steroids, and alemtuzumab induction were associated with developing BKV in the multivariate analysis. We concluded that BKV is not uncommon after renal transplantation. The determinants for BKV are male sex, older transplant recipients, and maintenance steroids. BKV adversely affected graft and patient survival. A unified approach for BKV and polyomavirus nephropathy treatment is needed.

Authors+Show Affiliations

Division of Nephrology and Transplantation, University of Kentucky, Lexington, Kentucky.Division of Nephrology and Transplantation, University of Kentucky, Lexington, Kentucky.Division of Nephrology and Transplantation, University of Kentucky, Lexington, Kentucky.Division of Nephrology and Transplantation, University of Kentucky, Lexington, Kentucky.Division of Nephrology and Transplantation, University of Kentucky, Lexington, Kentucky.Division of Nephrology and Transplantation, University of Kentucky, Lexington, Kentucky.Division of Nephrology and Transplantation, University of Kentucky, Lexington, Kentucky.Division of Nephrology and Transplantation, University of Kentucky, Lexington, Kentucky.Department of Pathology, University of Kentucky, Lexington, Kentucky.Division of Nephrology and Transplantation, University of Kentucky, Lexington, Kentucky.Department of Surgery, University of Kentucky, Lexington, Kentucky.Department of Surgery, University of Kentucky, Lexington, Kentucky.Division of Nephrology and Transplantation, University of Kentucky, Lexington, Kentucky.Division of Nephrology and Transplantation, University of Kentucky, Lexington, Kentucky. Electronic address: twaid@uky.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31399166

Citation

Malik, Omar, et al. "Prevalence, Risk Factors, Treatment, and Overall Impact of BK Viremia On Kidney Transplantation." Transplantation Proceedings, vol. 51, no. 6, 2019, pp. 1801-1809.
Malik O, Saleh S, Suleiman B, et al. Prevalence, Risk Factors, Treatment, and Overall Impact of BK Viremia on Kidney Transplantation. Transplant Proc. 2019;51(6):1801-1809.
Malik, O., Saleh, S., Suleiman, B., Ashqar, B., Maibam, A., Yaseen, M., ... Waid, T. (2019). Prevalence, Risk Factors, Treatment, and Overall Impact of BK Viremia on Kidney Transplantation. Transplantation Proceedings, 51(6), pp. 1801-1809. doi:10.1016/j.transproceed.2019.03.035.
Malik O, et al. Prevalence, Risk Factors, Treatment, and Overall Impact of BK Viremia On Kidney Transplantation. Transplant Proc. 2019;51(6):1801-1809. PubMed PMID: 31399166.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence, Risk Factors, Treatment, and Overall Impact of BK Viremia on Kidney Transplantation. AU - Malik,Omar, AU - Saleh,Sherif, AU - Suleiman,Belal, AU - Ashqar,Bilal, AU - Maibam,Amita, AU - Yaseen,Maria, AU - Elrefaei,Amro, AU - Hines,Abigail, AU - Cornea,Virgilius, AU - El-Husseini,Amr, AU - Mei,Xiaonan, AU - Gedaly,Roberto, AU - Castellanos,Ana Lia, AU - Waid,Thomas, PY - 2019/02/05/received PY - 2019/03/13/accepted PY - 2019/8/11/entrez SP - 1801 EP - 1809 JF - Transplantation proceedings JO - Transplant. Proc. VL - 51 IS - 6 N2 - BK viremia (BKV) is a recognized and potentially serious problem in renal transplantation. The risk factors and the impact of BKV on renal allograft and patient survival are controversial. This study reports an 8-year, single-center experience on the prevalence, risk factors, and outcomes of BKV in kidney transplant recipients. This is a retrospective analysis of all patients who received a kidney transplant at the University of Kentucky and had BK viral titers available from 2009 to 2017. BKV was defined by a polymerase chain reaction viral load of ≥ 10,000 copies per mL. Demographic, clinical, and laboratory data generated during routine outpatient follow up and inpatients records were collected. Independent risk factors for BKV were determined using uni- and multivariate analysis. Graft and patient survival was compared using Kaplan-Meier analysis, and the severity of polyomavirus nephropathy on biopsy was scored using the Banff 2017 classification. We identified 122 BK positive (19%) and 527 BK negative (81%) patients. BKV developed after a median of 115 days (range, 80-249 days) following kidney transplantation. The 1-, 5-, and 10-year graft survival was 97%, 75%, and 33% in the BKV group and 96%, 85%, and 71% in the BK negative group, respectively. Likewise, the 1-, 5-, and 10-year patient survival was 98%, 84%, and 52% in the BKV group and 98%, 92%, and 84% in the BK negative group. Male sex, age at transplantation, maintenance steroids, and alemtuzumab induction were associated with developing BKV in the multivariate analysis. We concluded that BKV is not uncommon after renal transplantation. The determinants for BKV are male sex, older transplant recipients, and maintenance steroids. BKV adversely affected graft and patient survival. A unified approach for BKV and polyomavirus nephropathy treatment is needed. SN - 1873-2623 UR - https://www.unboundmedicine.com/medline/citation/31399166/Prevalence,_Risk_Factors,_Treatment,_and_Overall_Impact_of_BK_Viremia_on_Kidney_Transplantation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0041-1345(19)30272-6 DB - PRIME DP - Unbound Medicine ER -