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BK polyomavirus DNAemia in pancreas transplant recipients compared to pancreas-kidney recipients.

Authors :
Yetmar ZA
Kudva YC
Seville MT
Bosch W
Dean PG
Huskey JL
Budhiraja P
Jarmi T
Kukla A
Beam E
Source :
Clinical transplantation [Clin Transplant] 2023 Nov; Vol. 37 (11), pp. e15135. Date of Electronic Publication: 2023 Sep 13.
Publication Year :
2023

Abstract

Background: BK polyomavirus (BKV) infection is a common complication of kidney transplantation. While BKV has been described in non-kidney transplant recipients, data are limited regarding its epidemiology and outcomes in pancreas transplant recipients.<br />Methods: We conducted a retrospective cohort study of adults who underwent pancreas transplantation from 2010-2020. The primary outcome was BKV DNAemia. Secondary outcomes were estimated glomerular filtration rate (eGFR) reduction by 30%, eGFR < 30 mL/min/1.73 m <superscript>2</superscript> , endstage kidney disease, and pancreas allograft failure. Cox regression with time-dependent variables was utilized.<br />Results: Four hundred and sixty-six patients were analyzed, including 74, 46, and 346 with pancreas transplant alone (PTA), pancreas-after-kidney, or simultaneous pancreas-kidney transplants, respectively. PTA recipients experienced a lower incidence of BKV DNAemia (8.8% vs. 32.9%; p < .001) and shorter duration of DNAemia (median 28.0 vs. 84.5 days). No PTA recipients with BKV DNAemia underwent kidney biopsy or developed endstage kidney disease. Lymphopenia, non-PTA transplantation, and older age were associated with BKV DNAemia, which itself was associated with pancreas allograft failure (adjusted hazard ratio 2.14, 95% confidence interval 1.27-3.60; p = .004). Among PTA recipients, BKV DNAemia was not associated with eGFR reduction or eGFR < 30 mL/min/1.73 m <superscript>2</superscript> .<br />Conclusions: BKV DNAemia was common among PTA recipients, though lower than a comparable group of pancreas-kidney recipients. However, BKV DNAemia was not associated with adverse native kidney outcomes and no PTA recipients developed endstage kidney disease. Conversely, BKV DNAemia was associated with pancreas allograft failure. Further studies are needed to estimate the rate of BKV nephropathy in this population, and further evaluate long-term kidney outcomes.<br /> (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Details

Language :
English
ISSN :
1399-0012
Volume :
37
Issue :
11
Database :
MEDLINE
Journal :
Clinical transplantation
Publication Type :
Academic Journal
Accession number :
37705389
Full Text :
https://doi.org/10.1111/ctr.15135