Prospective study of infection and nephropathy due to BK and JC polyomavirus in 76 kidney transplant recipients

Transplant Proc. 2008 Nov;40(9):2927-9. doi: 10.1016/j.transproceed.2008.08.098.

Abstract

Introduction: Nephropathy due to polyomavirus is usually diagnosed by renal biopsy after worsening of renal function. This is normally at an advanced stage of the disease.

Aim: To study the early detection of the presence of BK and JC polyomavirus in urine by monthly real-time quantitative polymerase chain reaction (PCR) assay.

Material and methods: The study included 76 kidney transplant recipients from cadaveric donors between August 2005 and July 2006 with a 1-year follow-up.

Results: Viruria was positive in 31 patients (40.7%) and viremia in 7 (9.2%), three of whom (3.9%) developed nephropathy. After reduction of the immunosuppression, the viruria became negative in 32.0% and the viremia in 42.8% of the patients. Renal function (creatinine clearance, aMDRD) at 1 year was 49.2 mL/min/1.73 m(2) in the patients with nephropathy and 64.3 mL/min/1.73 m(2) in the others. One-year patient and graft survival was 96%. No patient lost the graft due to nephropathy.

Conclusions: The detection of BK and JC polyomavirus by protocolized PCR enabled an early diagnosis of nephropathy, preventing graft loss with good renal function at 1 year.

MeSH terms

  • Adult
  • BK Virus*
  • Biopsy
  • Cadaver
  • Cohort Studies
  • DNA, Viral / genetics
  • DNA, Viral / isolation & purification
  • Female
  • Histocompatibility Testing
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • JC Virus*
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / immunology
  • Kidney Transplantation / pathology
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Polyomavirus Infections / pathology*
  • Retrospective Studies
  • Tissue Donors
  • Tumor Virus Infections / pathology*
  • Viral Load
  • Virus Replication

Substances

  • DNA, Viral
  • Immunosuppressive Agents