SP825BK VIRUS NEPHROPATHY IN A CENTER PERFORMING MAINLY LIVING KIDNEY TRANSPLANTATION

Abstract

Introduction and Aims: BK virus (BKV) is an emerging problem in kidney transplantation. However most of the data on BKV is derived from centers who perform cadaveric donor transplantation. In this study we evaluate the frequency and associated factors of BKV infection in a center performing mainly living donor transplantation. Methods: One hundred renal transplant patients, operated after June 2006 and still followed at our Transplantation Unit were included to the study. Quarterly visits were planned to examine urine for Decoy cells and to maesure BK virus DNA in blood and urine. Patient records were examined for acute rejection, delayed graft function, and biopsy. Serological examination for BK virus Ig G were performed in donors. Results: Renal transplant recipients were young or middle aged (median 35; between 20 and 65). Most of them were men and had living donors (81%). The demographical and laboratory characteristics of the patients are shown in Table 1. During the entire follow up period viruria rate was 12%, viremia rate was 6% and positivity of decoy cells were 13%. Negative and positive predictive values of Decoy cells for viruria was 93% and 69% respectively. The negative and positive predictive values of Decoy cells for viremia was 99.2% and 45.5% respectively. The comparison of the demographic, laboratory and clinical characteristics of the viruria or viremia positive and negative renal recipients are shown on Table‐2. BKV IgG was positive in all living donors. The treatment regimen changed in four patients, which the BKV DNA> 107 copies/ml in urine. Viremia and viruria disappeared completely in the follow‐up of three of the patients, whereas decreased in one patients. Graft loss did not happen due to BKVN in any patient, but one patient who was treated with leflunomid has graft loss due to reccurent glomerulonephritis. Conclusions: The frequency of BKV infection was lower in our transplant unit. Reduced doses of immunosupression seems to be the main factor to explain decreased frequency. However on active strategy for screening is still important in these patients also. (Table Presented).