Incidence of BK polyomavirus infection after kidney transplantation is independent of type of immunosuppressive therapy

Josephine Radtke; Nina Dietze; Lutz Fischer; Eike-Gert Achilles; Jun Li; Silke Scheidat; Friedrich Thaiss; Bjoern Nashan; Martina Koch

doi:10.1111/tid.12611

Incidence of BK polyomavirus infection after kidney transplantation is independent of type of immunosuppressive therapy

Transpl Infect Dis. 2016 Dec;18(6):850-855. doi: 10.1111/tid.12611. Epub 2016 Nov 30.

Authors

Josephine Radtke¹, Nina Dietze¹, Lutz Fischer¹, Eike-Gert Achilles¹, Jun Li¹, Silke Scheidat², Friedrich Thaiss², Bjoern Nashan¹, Martina Koch¹

Affiliations

¹ Department of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg-Eppendorf UKE, University Transplantation-Center UTC, Hamburg, Germany.
² Department of Internal Medicine III, University Medical Center Hamburg-Eppendorf UKE, University Transplantation-Center UTC, Hamburg, Germany.

PMID: 27639176
DOI: 10.1111/tid.12611

Abstract

Background: BK polyomavirus (BKV) infection and BKV nephropathy (BKVN) are risk factors for allograft function and survival.

Methods: We retrospectively analyzed BK viremia and BKVN in 348 patients who received a kidney transplantation donated after brain death (n=232) or living donation (n=116) between 2008 and 2013. A total of 266 patients were treated with standard immunosuppression consisting of basiliximab induction, calcineurin inhibitor (CNI), and mycophenolic acid (MPA, n=219) or everolimus (n=47); 82 patients received more intense immunosuppression with lymphocyte depletion, CNI and MPA (n=38) or everolimus (n=44).

Results: BK viremia occurred in 33 (9.5%) patients in the first year and in 7 (2.0%) recipients in the second year after transplantation. BKVN occurred in 4 (1.1%) patients in the first year. Donor and recipient age, diabetes, previous transplantation, and type of transplantation (donated after brain death vs living donation) were not risk factors (P>.05). BK incidence did not differ depending on induction or maintenance immunosuppression.

Conclusion: Incidence of BK viremia is independent of recipient characteristics, type of transplantation as well as induction and maintenance immunosuppression.

Keywords: BK virus; everolimus; immunosuppression.

MeSH terms

Adult
Aged
Antibodies, Monoclonal / administration & dosage
Antibodies, Monoclonal / adverse effects
Antibodies, Monoclonal / therapeutic use
BK Virus / drug effects*
BK Virus / isolation & purification
Basiliximab
Calcineurin Inhibitors / administration & dosage
Calcineurin Inhibitors / adverse effects
Calcineurin Inhibitors / therapeutic use
Everolimus / administration & dosage
Everolimus / adverse effects
Everolimus / therapeutic use
Female
Germany / epidemiology
Humans
Immunosuppression Therapy / adverse effects*
Immunosuppression Therapy / methods
Immunosuppressive Agents / administration & dosage
Immunosuppressive Agents / adverse effects
Immunosuppressive Agents / therapeutic use*
Incidence
Induction Chemotherapy / adverse effects
Induction Chemotherapy / methods
Kidney Diseases / epidemiology*
Kidney Diseases / virology
Kidney Transplantation / adverse effects*
Maintenance Chemotherapy / adverse effects
Maintenance Chemotherapy / methods
Male
Middle Aged
Mycophenolic Acid / administration & dosage
Mycophenolic Acid / adverse effects
Mycophenolic Acid / therapeutic use
Polyomavirus Infections / epidemiology*
Polyomavirus Infections / virology
Recombinant Fusion Proteins / administration & dosage
Recombinant Fusion Proteins / adverse effects
Recombinant Fusion Proteins / therapeutic use
Retrospective Studies
Risk Factors
Transplantation, Homologous / adverse effects
Tumor Virus Infections / epidemiology*
Tumor Virus Infections / virology
Viremia / epidemiology*
Viremia / virology

Substances

Antibodies, Monoclonal
Calcineurin Inhibitors
Immunosuppressive Agents
Recombinant Fusion Proteins
Basiliximab
Everolimus
Mycophenolic Acid