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. 2019 Jul 2;220(3):370-376.
doi: 10.1093/infdis/jiz114.

Impact of Pretransplant Donor BK Viruria in Kidney Transplant Recipients

Susanna K Tan  1 , Chunhong Huang  2 , Malaya K Sahoo  2 , Jenna Weber  2 , Jason Kurzer  2 , Margaret R Stedman  3 , Waldo Concepcion  4 , Amy E Gallo  4 , Diane Alonso  5 , Titte Srinivas  6 , Gregory A Storch  7 , Aruna K Subramanian  1 , Jane C Tan  3 , Benjamin A Pinsky  1   2
Affiliations

Impact of Pretransplant Donor BK Viruria in Kidney Transplant Recipients

Susanna K Tan et al. J Infect Dis. .

Abstract

Background: BK virus (BKV) is a significant cause of nephropathy in kidney transplantation. The goal of this study was to characterize the course and source of BKV in kidney transplant recipients.

Methods: We prospectively collected pretransplant plasma and urine samples from living and deceased kidney donors and performed BKV polymerase chain reaction (PCR) and immunoglobulin G (IgG) testing on pretransplant and serially collected posttransplant samples in kidney transplant recipients.

Results: Among deceased donors, 8.1% (17/208) had detectable BKV DNA in urine prior to organ procurement. BK viruria was observed in 15.4% (6/39) of living donors and 8.5% (4/47) of deceased donors of recipients at our institution (P = .50). BKV VP1 sequencing revealed identical virus between donor-recipient pairs to suggest donor transmission of virus. Recipients of BK viruric donors were more likely to develop BK viruria (66.6% vs 7.8%; P < .001) and viremia (66.6% vs 8.9%; P < .001) with a shorter time to onset (log-rank test, P < .001). Though donor BKV IgG titers were higher in recipients who developed BK viremia, pretransplant donor, recipient, and combined donor/recipient serology status was not associated with BK viremia (P = .31, P = .75, and P = .51, respectively).

Conclusions: Donor BK viruria is associated with early BK viruria and viremia in kidney transplant recipients. BKV PCR testing of donor urine may be useful in identifying recipients at risk for BKV complications.

Keywords: BK virus; PCR; donor; kidney transplantation; pretransplant; serology.

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Figures

Figure 1.
Figure 1.
Posttransplant urine BK virus (BKV) DNA levels in recipients of BK viruric donors who developed BK viruria posttransplant. In the 6 recipients of donors who were BK viruric at time of transplant, posttransplant urine BKV DNA levels increased several log-fold during the first 2–4 weeks of transplant that sustained for at least the first 3 months after transplant. The other 3 transplant recipients of BK viruric donors did not develop posttransplant BK viruria or viremia (not shown).
Figure 2.
Figure 2.
BK virus (BKV) VP1 sequencing of donors and posttransplant recipient. Virus found in paired donors and recipients were nearly genetically identical (<10 bp difference) and more similar than virus found in other pairs. Recipient 002 (arrows) was BK viruric with a genotype 1b2 virus and received a kidney from a donor who was viruric with a 1b1 virus. Virus identified in the recipient after transplant was a 1b1 virus similar to that in the donor. Reference accession numbers were as follows: BKV Ia: NC_001538; 1b1: AB211371; 1b2: AB260032; 1c: AB211377; II: AB263920; III: M23122; and IV: AB269826.
Figure 3.
Figure 3.
Pretransplant donor BK viruria is associated with early posttransplant recipient BK viruria. Recipients of BK viruric donors were more likely to develop BK viruria at 3 months (66.6% vs 7.8%; P < .001) and develop BK viruria earlier (log-rank test, P < .001) compared with kidney recipients from non-BK viruric donors. Abbreviations: BKV, BK virus; neg, negative; PCR, polymerase chain reaction; pos, positive.
Figure 4.
Figure 4.
Pretransplant donor BK viruria is associated with early posttransplant recipient BK viremia. Recipients of BK viruric donors were also more likely to develop BK viruria at 3 months (66.6% vs 8.9%; P < .001) and develop BK viruria earlier (log-rank test, P < .001) compared with kidney recipients from non-BK viruric donors. Abbreviations: BKV, BK virus; neg, negative; PCR, polymerase chain reaction; pos, positive.
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References

    1. Scadden JR, Sharif A, Skordilis K, Borrows R. Polyoma virus nephropathy in kidney transplantation. World J Transplant 2017; 7:329–38. - PMC - PubMed
    1. Trofe-Clark J, Sawinski D. BK and other polyomaviruses in kidney transplantation. Semin Nephrol 2016; 36:372–85. - PubMed
    1. Demey B, Tinez C, François C, et al. . Risk factors for BK virus viremia and nephropathy after kidney transplantation: a systematic review. J Clin Virol 2018; 109:6–12. - PubMed
    1. Laskin BL, Sullivan KE, Hester J, Goebel J, Davies SM, Jodele S. Antibodies to BK virus in children prior to allogeneic hematopoietic cell transplant. Pediatr Blood Cancer 2015; 62:1670–3. - PMC - PubMed
    1. Kumar S, Stecher G, Tamura K. MEGA7: molecular evolutionary genetics analysis version 7.0 for bigger datasets. Mol Biol Evol 2016; 33:1870–4. - PMC - PubMed

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