Isolated heart and liver transplant recipients are at low risk for polymavirus BKV nephropathy

Dechu P. Puliyanda, Nurmamet Amet, Archana Dhawan, Lara Hilo, Raju K. Radha, Suphamai Bunnapradist, Lawrence Czer, Paul Martin, Stanley Jordan, Mieko Toyoda

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background: BKV infection and nephropathy is a significant cause of allograft dysfunction in kidney transplantation. BKV viremia, rather than viruria, corresponds to BKV nephropathy. The prevalence of BKV viremia in non-renal solid organ transplants has not been systematically evaluated. Methods: We determined prevalence of BKV viremia in kidney, combined kidney-heart, kidney-liver, kidney-pancreas, kidney-heart-liver, and heart and liver transplant recipients using BKV-PCR. Results: Seven out of 173 (4%) kidney transplant recipients had BKV viremia, with BKV > 2 × 105 copies/mL in 6/7 and 1.9 × 103 in the remaining one patient. BKV viremia was not found in 24 heart transplant recipients, whereas 1/37 (2.7%) liver transplants showed low copy numbers (≤ 103). BKV-PCR ≤ 103 copies/mL were also found in one of each combined kidney-heart and kidney-liver transplant recipients. BKV nephropathy was proven by biopsy in 4/6 patients with high BKV viral loads. All six patients showed renal dysfunction, requiring reduction in immunosuppression and antiviral therapy. All four patients with low BKV viral loads (1.9 × 103 or ≤ 103) showed stable renal function after reduction of immunosuppression or no treatment, respectively. Conclusion: Higher BKV levels in plasma are associated with renal dysfunction. Kidney transplant recipients are at high risk compared with recipients of isolated heart or liver allografts, for development of BKV nephropathy.

Original languageEnglish
Pages (from-to)289-294
Number of pages6
JournalClinical Transplantation
Volume20
Issue number3
DOIs
StatePublished - May 1 2006
Externally publishedYes

Fingerprint

Kidney
Liver
Viremia
Viral Load
Immunosuppression
Allografts
Transplant Recipients
Transplants
Polymerase Chain Reaction
Kidney Transplantation
Antiviral Agents
Pancreas
Biopsy
Therapeutics
Infection

Keywords

  • Nephropathy
  • Polyomavirus
  • Transplantation

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Puliyanda, D. P., Amet, N., Dhawan, A., Hilo, L., Radha, R. K., Bunnapradist, S., ... Toyoda, M. (2006). Isolated heart and liver transplant recipients are at low risk for polymavirus BKV nephropathy. Clinical Transplantation, 20(3), 289-294. https://doi.org/10.1111/j.1399-0012.2005.00480.x

Isolated heart and liver transplant recipients are at low risk for polymavirus BKV nephropathy. / Puliyanda, Dechu P.; Amet, Nurmamet; Dhawan, Archana; Hilo, Lara; Radha, Raju K.; Bunnapradist, Suphamai; Czer, Lawrence; Martin, Paul; Jordan, Stanley; Toyoda, Mieko.

In: Clinical Transplantation, Vol. 20, No. 3, 01.05.2006, p. 289-294.

Research output: Contribution to journalArticle

Puliyanda, DP, Amet, N, Dhawan, A, Hilo, L, Radha, RK, Bunnapradist, S, Czer, L, Martin, P, Jordan, S & Toyoda, M 2006, 'Isolated heart and liver transplant recipients are at low risk for polymavirus BKV nephropathy', Clinical Transplantation, vol. 20, no. 3, pp. 289-294. https://doi.org/10.1111/j.1399-0012.2005.00480.x
Puliyanda, Dechu P. ; Amet, Nurmamet ; Dhawan, Archana ; Hilo, Lara ; Radha, Raju K. ; Bunnapradist, Suphamai ; Czer, Lawrence ; Martin, Paul ; Jordan, Stanley ; Toyoda, Mieko. / Isolated heart and liver transplant recipients are at low risk for polymavirus BKV nephropathy. In: Clinical Transplantation. 2006 ; Vol. 20, No. 3. pp. 289-294.
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abstract = "Background: BKV infection and nephropathy is a significant cause of allograft dysfunction in kidney transplantation. BKV viremia, rather than viruria, corresponds to BKV nephropathy. The prevalence of BKV viremia in non-renal solid organ transplants has not been systematically evaluated. Methods: We determined prevalence of BKV viremia in kidney, combined kidney-heart, kidney-liver, kidney-pancreas, kidney-heart-liver, and heart and liver transplant recipients using BKV-PCR. Results: Seven out of 173 (4{\%}) kidney transplant recipients had BKV viremia, with BKV > 2 × 105 copies/mL in 6/7 and 1.9 × 103 in the remaining one patient. BKV viremia was not found in 24 heart transplant recipients, whereas 1/37 (2.7{\%}) liver transplants showed low copy numbers (≤ 103). BKV-PCR ≤ 103 copies/mL were also found in one of each combined kidney-heart and kidney-liver transplant recipients. BKV nephropathy was proven by biopsy in 4/6 patients with high BKV viral loads. All six patients showed renal dysfunction, requiring reduction in immunosuppression and antiviral therapy. All four patients with low BKV viral loads (1.9 × 103 or ≤ 103) showed stable renal function after reduction of immunosuppression or no treatment, respectively. Conclusion: Higher BKV levels in plasma are associated with renal dysfunction. Kidney transplant recipients are at high risk compared with recipients of isolated heart or liver allografts, for development of BKV nephropathy.",
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AU - Amet, Nurmamet

AU - Dhawan, Archana

AU - Hilo, Lara

AU - Radha, Raju K.

AU - Bunnapradist, Suphamai

AU - Czer, Lawrence

AU - Martin, Paul

AU - Jordan, Stanley

AU - Toyoda, Mieko

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N2 - Background: BKV infection and nephropathy is a significant cause of allograft dysfunction in kidney transplantation. BKV viremia, rather than viruria, corresponds to BKV nephropathy. The prevalence of BKV viremia in non-renal solid organ transplants has not been systematically evaluated. Methods: We determined prevalence of BKV viremia in kidney, combined kidney-heart, kidney-liver, kidney-pancreas, kidney-heart-liver, and heart and liver transplant recipients using BKV-PCR. Results: Seven out of 173 (4%) kidney transplant recipients had BKV viremia, with BKV > 2 × 105 copies/mL in 6/7 and 1.9 × 103 in the remaining one patient. BKV viremia was not found in 24 heart transplant recipients, whereas 1/37 (2.7%) liver transplants showed low copy numbers (≤ 103). BKV-PCR ≤ 103 copies/mL were also found in one of each combined kidney-heart and kidney-liver transplant recipients. BKV nephropathy was proven by biopsy in 4/6 patients with high BKV viral loads. All six patients showed renal dysfunction, requiring reduction in immunosuppression and antiviral therapy. All four patients with low BKV viral loads (1.9 × 103 or ≤ 103) showed stable renal function after reduction of immunosuppression or no treatment, respectively. Conclusion: Higher BKV levels in plasma are associated with renal dysfunction. Kidney transplant recipients are at high risk compared with recipients of isolated heart or liver allografts, for development of BKV nephropathy.

AB - Background: BKV infection and nephropathy is a significant cause of allograft dysfunction in kidney transplantation. BKV viremia, rather than viruria, corresponds to BKV nephropathy. The prevalence of BKV viremia in non-renal solid organ transplants has not been systematically evaluated. Methods: We determined prevalence of BKV viremia in kidney, combined kidney-heart, kidney-liver, kidney-pancreas, kidney-heart-liver, and heart and liver transplant recipients using BKV-PCR. Results: Seven out of 173 (4%) kidney transplant recipients had BKV viremia, with BKV > 2 × 105 copies/mL in 6/7 and 1.9 × 103 in the remaining one patient. BKV viremia was not found in 24 heart transplant recipients, whereas 1/37 (2.7%) liver transplants showed low copy numbers (≤ 103). BKV-PCR ≤ 103 copies/mL were also found in one of each combined kidney-heart and kidney-liver transplant recipients. BKV nephropathy was proven by biopsy in 4/6 patients with high BKV viral loads. All six patients showed renal dysfunction, requiring reduction in immunosuppression and antiviral therapy. All four patients with low BKV viral loads (1.9 × 103 or ≤ 103) showed stable renal function after reduction of immunosuppression or no treatment, respectively. Conclusion: Higher BKV levels in plasma are associated with renal dysfunction. Kidney transplant recipients are at high risk compared with recipients of isolated heart or liver allografts, for development of BKV nephropathy.

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KW - Polyomavirus

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