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BK Virus Infection After Kidney Transplantation

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https://www.readbyqxmd.com/read/30026258/occurrence-and-regression-of-bk-polyomavirus-associated-carcinoma-a-clinical-and-next-generation-sequencing-study
#1
Fangxiang Fu, Wenfeng Deng, Siyuan Yu, Yanna Liu, Lixin Yu, Rumin Liu, Jiping Lang, Dianxiang Geng, Jian Geng, Jiangtao Li, Gang Huang, Minhua Luo, Fu Xiong, Chin-Lee Wu, Yun Miao
Low-level BK polyomavirus (BKPyV) shedding is seen in at least 10% of seropositive immunocompetent adults. Moreover, BKPyV infection is highly prevalent amongst immunocompromised populations, yet little is known on its relationship with malignancy. We studied a female patient with BKPyV-associated and donor-derived de novo high-grade sarcomatoid urothelial carcinoma developed 8 years after kidney transplantation from a male donor. Through whole-genome sequencing, we discovered integration of genotype IV BKPyV genome into the non-coding RNA (ncRNA) intronic region of human chromosome 18...
August 31, 2018: Clinical Science (1979-)
https://www.readbyqxmd.com/read/29877001/clinical-significance-of-isoagglutinin-titer-with-the-current-desensitization-protocol-in-abo-incompatible-kidney-transplantation
#2
Chung Hee Baek, Hyosang Kim, Won Seok Yang, Duck Jong Han, Su-Kil Park
AIM: ABO-incompatible (ABOi) kidney transplantation (KT) has become a routine procedure with graft survival rates comparable to those of ABO-compatible KT. However, the clinical significance of the isoagglutinin titer in ABOi KT remains uncertain. Therefore, in this study, we analyzed the clinical outcomes of ABOi KT according to the baseline and postoperative isoagglutinin titer. METHODS: All patients who received ABOi KT between 2009 and 2013 were reviewed and followed up until December 2016...
June 7, 2018: Nephrology
https://www.readbyqxmd.com/read/29765170/bk-virus-induced-renal-allograft-nephropathy
#3
Karel Krejci, Tomas Tichy, Jana Bednarikova, Kamil Zamboch, Josef Zadrazil
BK virus nephropathy (BKVN) is a serious opportunistic infection threatening renal function especially during the first year after transplantation. Its incidence is now on the rise and is closely related to the level of the recipient's immune system inhibition. This is more intensive with current trends in transplantation medicine, where more potent immunosuppressive protocols are used and more aggressive antirejection therapy is applied. In the absence of BK virus (BKV) specific therapy and limited treatment options for advanced BKVN, active screening of BKV replication and subsequent preemptive adjustment of immunosuppression are essential measures to prevent BKVN...
September 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29752413/everolimus-with-reduced-calcineurin-inhibitor-exposure-in-renal-transplantation
#4
Julio Pascual, Stefan P Berger, Oliver Witzke, Helio Tedesco, Shamkant Mulgaonkar, Yasir Qazi, Steven Chadban, Federico Oppenheimer, Claudia Sommerer, Rainer Oberbauer, Yoshihiko Watarai, Christophe Legendre, Franco Citterio, Mitchell Henry, Titte R Srinivas, Wen-Lin Luo, AnaMaria Marti, Peter Bernhardt, Flavio Vincenti
Background Everolimus permits reduced calcineurin inhibitor (CNI) exposure, but the efficacy and safety outcomes of this treatment after kidney transplant require confirmation. Methods In a multicenter noninferiority trial, we randomized 2037 de novo kidney transplant recipients to receive, in combination with induction therapy and corticosteroids, everolimus with reduced-exposure CNI (everolimus arm) or mycophenolic acid (MPA) with standard-exposure CNI (MPA arm). The primary end point was treated biopsy-proven acute rejection or eGFR<50 ml/min per 1...
July 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29748530/bk-virus-a-cause-for-concern-in-thoracic-transplantation
#5
REVIEW
Markus J Barten, Andreas Zuckermann
Human BK polyomavirus (BKV) infection is poorly documented in heart and lung transplant patients. BK viruria and viremia have been estimated to affect 19% and 5% of heart transplant recipients, respectively. Data are limited, especially for lung transplantation, but the proportion of patients progressing from BK viruria to viremia or BKV-related nephropathy (BKVN) appears lower than in kidney transplantation. Nevertheless, a number of cases of BKVN have been reported in heart and lung transplant patients, typically with late diagnosis and generally poor outcomes...
May 11, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29731098/efficacy-and-safety-of-induction-therapy-in-kidney-transplantation-a-network-meta-analysis
#6
S D Hwang, J H Lee, S W Lee, K-M Park, J K Kim, M-J Kim, J H Song
BACKGROUND: Rejection and infection can occur after kidney transplantation and are important factors in preserving graft kidney function. The use of immunosuppressant agents in transplantation is therefore important, and the question of which induction therapy should be used as an immunosuppressant is controversial. OBJECTIVE: The goal of this study was to assess the comparative benefits and harms of various maintenance immunosuppressive induction agents in adults undergoing kidney transplantation by using a network meta-analysis and to generate rankings of the different immunosuppressive regimens according to their safety and efficacy...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29731069/bk-virus-infection-in-thai-kidney-transplant-recipients-a-single-center-experience
#7
P Skulratanasak, J Mahamongkhonsawata, M Chayakulkeereeb, N Larpparisutha, N Premasathiana, A Vongwiwatana
INTRODUCTION: BK virus-associated nephropathy (BKVAN) is a significant cause of allograft dysfunction and failure in kidney transplant recipients. Early detection and proper adjustment of immunosuppression is the best method for treatment of this condition and to improve long-term allograft outcome. Here, we reported the prevalence and risk factors of BK virus (BKV) infection in our population. METHODS: We retrospectively reviewed kidney transplant recipients at Siriraj Hospital between January 2012 and December 2015 who had been investigated using real-time polymerase chain reaction BK viral load...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29688849/cryptococcoma-of-a-transplanted-kidney-in-a-patient-presenting-with-recurrent-urinary-tract-infection-a-case-report
#8
Albert Z Muranda, Ludolf Greeff, Mike M Sathekge, Thabo Lengano, Victor O L Karusseit
BACKGROUND: Cryptococcosis is an important opportunistic infection of organ transplant recipients. It is the third most common fungal infection of transplant patients and occurs especially in kidney recipients. Cryptococcus neoformans is a ubiquitous fungus which infects humans by inhalation of spores. C. gattii has more recently been recognised as a pathogen. Infection commonly is disseminated affecting mainly the central nervous system and the lungs. Cryptococcoma, a localised form of the disease, has been described in various organs...
April 23, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29661424/intravenous-immunoglobulin-and-rituximab-in-hla-highly-sensitized-kidney-transplant-recipients
#9
S Querido, A Weigert, T Adragão, J Henriques, R Birne, P Matias, C Jorge, C Nascimento, M Bruges, D Machado
INTRODUCTION: HLA-sensitized patients are penalized both in the access to kidney transplantation (KT) and, once transplanted, in the incidence of rejections and long-term allograft survival despite aggressive induction and maintenance therapy. METHODS: This study retrospectively evaluates the impact of combining T- and B-cell-depleting agents and intravenous immunoglobulin for induction therapy in 45 highly sensitized KT patients (anti-panel reactive antibodies >60%, positive flow cytometry crossmatch or donor specific antibodies at the time of transplantation)...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29599935/bk-virus-associated-collecting-duct-carcinoma-of-the-renal-allograft-in-a-kidney-pancreas-allograft-recipient
#10
Myriam Dao, Adrien Pécriaux, Thomas Bessede, Antoine Dürrbach, Charlotte Mussini, Catherine Guettier, Sophie Ferlicot
BK polyomavirus (BKV) nephropathy is a major concern in renal transplantation. Its main consequence is graft loss, which occurs in more than 50% of the cases. De novo renal cell carcinoma in renal allograft is a very rare event. Most of these tumors are papillary or clear cell carcinomas. We report herein the first case of collecting duct carcinoma of the renal allograft in a kidney-pancreas allograft adult recipient. Collecting duct carcinoma occurs long after the cure of a BKV nephropathy. At this time, BKV viremia and viruria were negative as well as the immunostaining for SV40 in the non-tumor kidney...
March 13, 2018: Oncotarget
https://www.readbyqxmd.com/read/28933173/-cytomegalovirus-and-polyomavirus-infection-after-renal-transplantation
#11
Jana Machová, Tomáš Reischig
Viral infections are among the most common infectious complications affecting transplant recipients. Due to immunosuppressive therapy predominantly affecting cellular immunity and thus successfully reducing the incidence of acute rejection, there is a higher incidence of viral infections. Herpesviruses and polyomaviruses are ubiquitous pathogens which have the ability to persist in a state of latent infection. In addition to post-transplant reactivation, donor-induced primoinfection can also occur, leading to increased morbidity and contributing to decreased survival of patients...
December 0: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28923623/mycophenolate-mofetil-withdrawal-with-conversion-to-everolimus-to-treat-bk-virus-infection-in-kidney-transplant-recipients
#12
RANDOMIZED CONTROLLED TRIAL
D Wojciechowski, S Chandran, A Webber, R Hirose, F Vincenti
BACKGROUND: BK virus (BKV) is a significant post-transplant infection. Mammalian target of rapamycin inhibitors (mTORis) reduce BKV large T antigen expression in vitro and are associated with lower rates of BKV infection when used as de novo immunosuppression in clinical studies. METHODS: We performed a prospective, single-center, randomized, open label pilot trial to evaluate the impact of mycophenolate mofetil (MMF) withdrawal with conversion to the mTORi everolimus versus a 50% reduction of the MMF dose for the treatment of BKV infection after kidney transplantation...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28514587/bk-virus-after-kidney-transplantation-a-review-of-screening-and-treatment-strategies-and-a-summary-of-the-massachusetts-general-hospital-experience
#13
Kassem Safa, Eliot Heher, Hannah Gilligan, Winfred Williams, Nina Tolkoff-Rubin, David Wojciechowski
BK virus (BKV) is a common infection encountered after kidney transplantation. BKV is associated with a spectrum of manifestations, starting with sub-clinical viruria, followed by viremia and BKV-associated nephropathy. Standard of care includes routine post-transplant screening for BK viruria and/or viremia. Both the Kidney Disease Improving Global Outcomes and the American Society of Transplantation Infectious Diseases Community of Practice have published screening recommendations. Although they vary slightly, they both highlight the importance of early detection with serial screening...
2015: Clinical Transplants
https://www.readbyqxmd.com/read/28509156/bk-virus-induced-acute-motor-axonal-polyneuropathy-in-a-renal-transplant-patient
#14
Hulya Taskapan, Uner Kayabas, Baris Otlu, Ozden Kamisli, Cisel Yilmaz Yaprak, Fatma Terzioglu Sahin
Neurological complications are not uncommon in patients with renal transplantation, mostly affecting the central nervous system, and less frequently the peripheral nerves. BK virus infection is relatively common in transplant recipients and in some cases may lead to neurological complications. In this report, we present an interesting case of a patient who developed acute axonal motor polyneuropathy in the course of BK virus infection 3 months after kidney transplantation. After BK virus clearence in blood, a significant improvement was noted in her polyneuropathy...
May 2016: CEN Case Reports
https://www.readbyqxmd.com/read/28452096/kidney-transplant-after-hematopoietic-cell-transplant-in-pediatrics-infectious-and-immunosuppressive-considerations
#15
REVIEW
Christen L Ebens, Angela R Smith, Priya S Verghese
Pediatric patients requiring kidney transplant after hematopoietic cell transplant receive multiple courses of immunosuppression placing them at risk for infection. To elucidate potential risk factors for infection, we compared the immunosuppressive regimens and infectious complications of pediatric kidney transplant recipients at a single institution who had previously undergone hematopoietic cell transplant from different donors to similar patients reported in the literature. Among the initial four post-hematopoietic cell transplant kidney transplant patients reviewed, viremia episodes were universal, including BK virus, Epstein-Barr virus, and human herpesvirus-6, with one death from presumed BK virus encephalitis...
August 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28355579/stability-of-bk-polyomavirus-igg-seroreactivity-and-its-correlation-with-preceding-viremia
#16
Herman F Wunderink, Els van der Meijden, Caroline S van der Blij-de Brouwer, Hans L Zaaijer, Aloys C M Kroes, Erik W van Zwet, Joris I Rotmans, Mariet C W Feltkamp
BACKGROUND: Recently we showed that the level of BK polyomavirus (BKPyV) IgG seroreactivity in kidney donors predicted viremia and BKPyV-associated nephropathy in kidney transplant recipients (KTRs). This observation could be explained by assuming a direct association between BKPyV seroreactivity and the amount of persistent infectious virus in the renal allograft. OBJECTIVES: Since the renal BKPyV reservoir is probably sowed by viremia during primary BKPyV infection, we systematically analysed the dynamics of BKPyV IgG seroreactivity in relation to preceding BKPyV viremia in KTRs and healthy individuals...
May 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28340828/prevalence-and-risk-factors-of-bk-viremia-in-patients-with-kidney-transplantation-a-single-center-experience-from-turkey
#17
S E Dogan, Z K Celebi, S Akturk, S Kutlay, A Tuzuner, K Keven, S Sengul
BACKGROUND: BK virus is the cause of nephropathy, which can progress to graft loss after kidney transplantation. In this study, we aimed to investigate the prevalence and risk factors of BK viremia in patients with kidney transplantation at our center. METHODS: This was a retrospective single-center study. We included recipients transplanted between 2010 and 2015. Patients were stratified according to BK virus DNA follow-up values into three groups (0-999 copies/mL, 1000-9999 copies/mL and ≥10,000 copies/mL)...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340807/prevalence-of-human-herpesvirus-8-and-bk-polyoma-virus-infections-in-end-stage-renal-disease-and-the-influence-of-renal-transplantation
#18
A Turkmen, O Guven, S Mese, A Agacfidan, B Yelken, M Onel, Y Caliskan, G Celik, S Turkoglu, B Kocak
Viral infections lead to significant morbidity and mortality in kidney transplant recipients. We evaluated 49 kidney transplant recipients for human herpesvirus 8 (HHV-8) and BK polyomavirus infections in conjunction with data obtained from 43 donors. The seroprevalence of HHV-8 was 6.9% in donors and 12.2% in recipients. HHV-8 DNA was detected below the limit of quantification (<5000 copies/mL) in a recipient with HHV-8 seropositivity at the pretransplant period and was undetectable at month 3 after transplantation...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28273393/a-retrospective-study-to-describe-the-epidemiology-and-outcomes-of-opportunistic-infections-after-abdominal-organ-transplantation
#19
Mia Helfrich, Peter Dorschner, Kathryn Thomas, Valentina Stosor, Michael G Ison
BACKGROUND: Most epidemiologic studies of opportunistic infections (OI) following abdominal organ transplantation are derived prior to the era of contemporary immunosuppression and prophylaxis. These studies suggest that most OI occur within the first 6 months post transplant. METHOD: In this single-center, retrospective cohort study, we describe the epidemiology of OI in 359 consecutive abdominal organ transplant recipients, in the era of contemporary prophylaxis practices and alemtuzumab induction in kidney and simultaneous pancreas-kidney transplant recipients...
June 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28265581/impact-of-desensitization-on-antiviral-immunity-in-hla-sensitized-kidney-transplant-recipients
#20
Mieko Toyoda, Bong-Ha Shin, Shili Ge, James Mirocha, David Thomas, Maggie Chu, Edgar Rodriguez, Christine Chao, Anna Petrosyan, Odette A Galera, Ashley Vo, Jua Choi, Alice Peng, Joseph Kahwaji, Stanley C Jordan
Viral infections represent significant morbidity and mortality factors in kidney transplant recipients, with CMV, EBV, and BKV infections being most common. Desensitization (DES) with IVIg and rituximab with/without plasma exchange followed by kidney transplantation with alemtuzumab induction increased successful transplant rates in HLA-sensitized patients but may represent an increased risk for viral infections due to severe lymphocyte depletion. Here, we report on the posttransplant viral infection status in 372 DES versus 538 non-DES patients...
2017: Journal of Immunology Research
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