Stabilization of renal function after the first year of follow‐up in kidney transplant recipients treated for significant BK polyomavirus infection or BK polyomavirus‐associated nephropathy

Marie‐Christine Simard‐Meilleur; Paule Bodson‐Clermont; Gilles St‐Louis; Michel R. Pâquet; Catherine Girardin; Marie‐Chantal Fortin; Héloïse Cardinal; Marie‐Josée Hébert; Renée Lévesque; Edith Renoult

doi:10.1111/tid.12681

journal article Apr 17, 2017

Stabilization of renal function after the first year of follow‐up in kidney transplant recipients treated for significant BK polyomavirus infection or BK polyomavirus‐associated nephropathy

Marie‐Christine Simard‐Meilleur Paule Bodson‐Clermont Gilles St‐Louis Michel R. Pâquet Catherine Girardin Marie‐Chantal Fortin Héloïse Cardinal Marie‐Josée Hébert Renée Lévesque Edith Renoult

Transplant Infectious Disease Vol. 19 No. 3 · Wiley

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Abstract

AbstractBackgroundBK polyomavirus virus (BKPyV) screening and immunosuppression reduction effectively prevent graft loss due to BKPyV‐associated nephropathy (BKPVAN) during the first year after transplantation. The aim of our study was to evaluate the impact of this infection during longer follow‐up periods.MethodsWe reviewed the outcome of our screening and immunosuppression reduction protocol in 305 patients who received a kidney transplant between March 2008 and January 2013. Quantitative BKPyV DNA surveillance in plasma was performed at 1, 2, 3, 6, 9, and 12 months after transplantation. Patients with significant viremia and/or biopsy‐proven BKPVAN were treated with immunosuppression reduction and leflunomide.ResultsDuring the first post‐transplant year, 24 patients (7.9%) developed significant viremia at a median time of 95 days, and 18 patients had BKPVAN; 23 of the 24 (7.5%) were treated according to our protocol (group BKV+); 225 patients (73.8%) did not develop any BK viremia (group BKV−). Allograft function was similar in both groups at 1 month post transplantation (P=.87), but significantly worse at 1 year in the BKV+ group (P=.002). Thereafter, kidney function stabilized in the BKV+ group and no differences in patient and graft survival were seen between the groups after a median follow‐up of 4 years.ConclusionsWe confirm the early occurrence of BKPyV replication after transplantation and the short‐term decline in renal function. However, early detection of BKPyV replication, prompt diagnosis, and reduction in immunosuppression may offer long‐term benefits for graft function.

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References

38

[1]

10.1097/00007890-199901150-00018

[2]

10.1097/00007890-199903270-00022

[3]

10.1056/nejmoa020439

[4]

Ramos E "BK virus nephropathy diagnosis and treatment: Experience at the University of Maryland Renal Transplant Program" Clin Transplant (2002)

[5]

10.2215/cjn.00920207

[6]

10.1097/01.tp.0000156165.83160.09

[7]

10.1097/tp.0b013e318166cba8

[8]

10.1111/j.1600-6143.2005.00742.x

[9]

10.1097/tp.0b013e3181fed03d

[10]

10.1586/14787210.5.1.105

[11]

10.1111/tri.12134

[12]

10.1056/nejm200503173521125

[13]

10.1097/01.tp.0000181149.76113.50

[14]

10.1097/01.tp.0000441825.72639.4f

[15]

10.1097/tp.0b013e31826690c6

[16]

10.1111/j.1600-6143.2009.02952.x

[17]

10.1016/j.diagmicrobio.2014.09.024

[18]

10.1046/j.1600-6143.2004.00603.x

[19]

10.1111/ajt.12110

[20]

10.12659/ajcr.894314

[21]

10.1111/j.1600-6143.2005.00934.x

[22]

10.2215/cjn.12531211

[23]

10.1097/tp.0b013e31819cc383

[24]

10.1097/tp.0b013e318169c794

[25]

10.1038/sj.ki.5000040

[26]

10.1097/tp.0b013e318197c17d

[27]

10.1097/01.asn.0000023435.07320.81

[28]

10.1097/tp.0b013e3182a68935

[29]

10.1111/j.1600-6143.2012.04320.x

[30]

10.1111/ajt.12218

[31]

10.1111/j.1523-1755.2005.00602.x

[32]

10.1097/00007890-200202150-00008

[33]

10.1111/j.1600-6143.2005.01152.x

[34]

10.1128/jvi.01737-09

[35]

10.2215/cjn.03930907

[36]

10.1016/j.transproceed.2014.11.051

[37]

10.1111/j.1600-6143.2010.03310.x

[38]

10.1097/tp.0b013e31825a505d

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Details

Published: Apr 17, 2017
Vol/Issue: 19(3)
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Authors

M

Marie‐Christine Simard‐Meilleur