Pretransplantation donor-recipient pair seroreactivity against BK polyomavirus predicts viremia and nephropathy after kidney transplantation.
2017
Wunderink, Herman F. | van Der Meijden, E. | van Der Blij-de Brouwer, C.S. | Mallat, M.J.K. | Haasnoot, G.W. | van Zwet, E.W. | Claas, E.C.J. | de Fijter, J.W. | Kroes, A.C.M. | Arnold, Françoise | Touzé, Antoine | Claas, F.H.J. | Rotmans, J.I. | Feltkamp, M.C.W. | Department of Medical Microbiology ; Leiden University Medical Center (LUMC) ; Universiteit Leiden = Leiden University-Universiteit Leiden = Leiden University | Department of Nephrology ; Leiden University Medical Center (LUMC) ; Universiteit Leiden = Leiden University-Universiteit Leiden = Leiden University | Department of Immunohematology and Blood Transfusion ; Leiden University Medical Center (LUMC) ; Universiteit Leiden = Leiden University-Universiteit Leiden = Leiden University | Department of Medical Statistics and Bioinformatics ; Leiden University Medical Center (LUMC) ; Universiteit Leiden = Leiden University-Universiteit Leiden = Leiden University | Infectiologie et Santé Publique (UMR ISP) ; Institut National de la Recherche Agronomique (INRA)-Université de Tours (UT) | Dutch Kidney Foundation grant 13A1D302
International audience
显示更多 [+] 显示较少 [-]英语. Kidney transplant donors are not currently implicated in predicting BK polyomavirus (BKPyV) infection in kidney transplant recipients. It has been postulated, however, that BKPyV infection originates from the kidney allograft. Because BKPyV seroreactivity correlates with BKPyV replication and thus might mirror the infectious load, we investigated whether BKPyV seroreactivity of the donor predicts viremia and BKPyV-associated nephropathy (BKPyVAN) in the recipient. In a retrospective cohort of 407 living kidney donor-recipient pairs, pretransplantation donor and recipient sera were tested for BKPyV IgG levels and correlated with the occurrence of recipient BKPyV viremia and BKPyVAN within 1 year after transplantation. Donor BKPyV IgG level was strongly associated with BKPyV viremia and BKPyVAN (p < 0.001), whereas recipient BKPyV seroreactivity showed a nonsignificant inverse trend. Pairing of high-BKPyV-seroreactive donors with low-seroreactive recipients resulted in a 10-fold increased risk of BKPyV viremia (hazard ratio 10.1, 95% CI 3.5-29.0, p < 0.001). In multivariate analysis, donor BKPyV seroreactivity was the strongest pretransplantation factor associated with viremia (p < 0.001) and BKPyVAN (p = 0.007). The proportional relationship between donor BKPyV seroreactivity and recipient infection suggests that donor BKPyV seroreactivity reflects the infectious load of the kidney allograft and calls for the use of pretransplantation BKPyV serological testing of (potential) donors and recipients.
显示更多 [+] 显示较少 [-]