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BK viremia

Allison Ducharme-Smith, Ben Z Katz, Amy E Bobrowski, Carl L Backer, Elfriede Pahl
BKV infection and nephropathy complicate pediatric HTx, but the incidence and time course of the disease are unknown. We assessed the incidence of BKV infection and its association with kidney dysfunction in pediatric HTx recipients. A single center prospective study compared pediatric (<18 years) HTx recipients, with and without BKV infection, who received an allograft between September 2013 and December 2014. Screening of urine for BKV was performed prior to transplant, and at week 1, and at months 3, 6, 9, 12, and 15 months post-transplantation...
October 20, 2016: Pediatric Transplantation
Aurore Barthélemy, Nicolas Bouvier, Renaud Verdon, Valérie Chatelet, Bruno Hurault de Ligny
We report the case of a human immunodeficiency virus-seropositive patient whose initial kidney transplant failed because of BK polyomavirus-induced nephropathy, and who underwent a second transplantation 3 years later. BK viruria was detected 1 day after transplantation. After 1 month, BK viremia developed along with a donor-specific antibody. After decreasing tacrolimus and mycophenolic acid and 2 courses of intravenous immunoglobulins, BK viremia and donor-specific antibody permanently disappeared, with stable renal function...
September 26, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
W James Chon, Nidhi Aggarwal, Masha Kocherginsky, Brenna Kane, Jozefa Sutor, Michelle A Josephson
BACKGROUND: Although early monitoring of BK virus infection in renal transplant patients has led to improved outcomes over the past decade, it remains unclear whether monitoring for viremia is the best screening tool for BK virus nephropathy (BKVN). METHODS: We conducted a retrospective review of the medical records of 368 renal transplant recipients who had a minimum of 18 months of posttransplantation follow-up. The relationship between the presence of BK viruria and a composite end point of BK viremia/BKVN was established, and the predictive value of high-grade BK viruria for development of viremia/BKVN was determined...
September 2016: Kidney Research and Clinical Practice
J Radtke, N Dietze, L Fischer, E-G Achilles, J Li, S Scheidat, F Thaiss, B Nashan, M Koch
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. 266 patients were treated with standard immunosuppression consisting of basiliximab induction, calcineurin inhibitor (CNI), and mycophenolate (MPA, n = 219) or everolimus (n = 47)...
September 17, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
H Kim, H Yu, C H Baek, D J Han, S-K Park
BACKGROUND: Although high-dose steroid therapy has been attempted for the management of clinically suspected allograft rejection, before testing for BK viral activity or acute cellular rejection accompanied by BKN, its long-term outcome remains unknown. We investigated the impact of high-dose steroids on BK viral activity and long-term graft outcomes in patients with BK viremia. METHODS: The study population comprised 144 kidney transplant recipients with BK viremia...
September 13, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Gerold Thölking, Christina Schmidt, Raphael Koch, Katharina Schuette-Nuetgen, Dirk Pabst, Heiner Wolters, Iyad Kabar, Anna Hüsing, Hermann Pavenstädt, Stefan Reuter, Barbara Suwelack
Immunosuppression is the major risk factor for BK virus nephropathy (BKVN) after renal transplantation (RTx). As the individual tacrolimus (Tac) metabolism rate correlates with Tac side effects, we hypothesized that Tac metabolism might also influence the BKV infection risk. In this case-control study RTx patients with BK viremia within 4 years after RTx (BKV group) were compared with a BKV negative control group. The Tac metabolism rate expressed as the blood concentration normalized by the daily dose (C/D ratio) was applied to assess the Tac metabolism rate...
2016: Scientific Reports
A Perkowska-Ptasińska, D Dęborska-Materkowska, M Serwańska-Świętek, M Wszoła, A Kwiatkowski, M Durlik
BACKGROUND: We report 2 cases of polyomavirus-associated nephropathy (PyVAN) emerging within the initial 8 posttransplant weeks. These cases were characterized by intraepithelial BK virus replication without typical nuclear inclusions in epithelial cells. METHODS AND RESULTS: A 70-year-old male recipient of a cadaveric kidney transplant had experienced unsatisfying graft function since the time of transplantation (Tx). One month after Tx, results of a graft biopsy revealed mild tubulointerstitial inflammation...
June 2016: Transplantation Proceedings
Jelena Stojanovic, Anna Adamusiak, Nicos Kessaris, Pankaj Chandak, Zubir Ahmed, Neil J Sebire, Grainne Walsh, Helen E Jones, Stephen D Marks, Nizam Mamode
BACKGROUND: Blood group incompatible transplantation (ABOi) in children is rare as pretransplant conditioning remains challenging and concerns persist about the potential increased risk of rejection. METHODS: We describe the results of 11 ABOi pediatric renal transplant recipients in the 2 largest centers in the United Kingdom, sharing the same tailored desensitization protocol. Patients with pretransplant titers of 1 or more in 8 received rituximab 1 month before transplant; tacrolimus and mycophenolate mofetil were started 1 week before surgery...
July 12, 2016: Transplantation
Joanna M Schaenman, Yael Korin, Tiffany Sidwell, Fadi Kandarian, Nicholas Harre, David Gjertson, Erik L Lum, Uttam Reddy, Edmund Huang, Phuong T Pham, Suphamai Bunnapradist, Gabriel M Danovitch, Jefferey Veale, H Albin Gritsch, Elaine F Reed
BACKGROUND: BK virus infection remains an important cause of loss of allograft function after kidney transplantation. We sought to determine whether polyfunctional T cells secreting multiple cytokines simultaneously, which have been shown to be associated with viral control, could be detected early after start of BK viremia, which would provide insight into the mechanism of successful antiviral control. METHODS: Peripheral blood mononuclear cells collected during episodes of BK viral replication were evaluated by multiparameter flow cytometry after stimulation by overlapping peptide pools of BK virus antigen to determine frequency of CD8+ and CD4+ T cells expressing 1 or more cytokines simultaneously, as well as markers of T-cell activation, exhaustion, and maturation...
July 7, 2016: Transplantation
Mauro Dugo, Margherita Mangino, Mario Meola, Ilaria Petrucci, Maria Luisa Valente, Licia Laurino, Mario Stella, Stefania Mastrosimone, Anna Brunello, Bice Virgilio, Monica Rizzolo, Maria Cristina Maresca
BK polyomavirus (BKV) is an emerging pathogen in immunocompromised patients. BKV infection occurs in 1-9 % of renal transplants and causes chronic nephropathy or graft loss. Diagnosis of BKV-associated nephropathy (BKVAN) is based on detection of viruria then viremia and at least a tubule-interstitial nephritis at renal biopsy. This paper describes the ultrasound and color Doppler (US-CD) features of BKVAN. Seventeen patients affected by BKVAN were studied using a linear bandwidth 7-12 MHz probe. Ultrasound showed a widespread streak-like pattern with alternating normal echoic and hypoechoic streaks with irregular edges from the papilla to the cortex...
June 24, 2016: Journal of Nephrology
Hanen Boukoum, Imen Nahdi, Wissal Sahtout, Habib Skiri, Michel Segondy, Mahjoub Aouni
The human polyomaviruses BKPyV and JCPyV are members of Polyomaviridae family and after primary infections they persist as latent infection especially in the kidneys. BKVPy reactivation is mainly related to a renal nephropathy and JCV reactivation can induce the progressive multifocal leukoencephalopathy. The aim of this study was to investigate and to compare the presence of BKPyV and JCPyV in urine and plasma samples from immunocompromised and immunocompetent groups. The viral detection and quantification was done by a real time PCR from 100 healthy individuals and from 72 kidney transplanted patients (KTx) enrolled in a prospective study...
August 2016: Microbial Pathogenesis
Gang Zeng, Yuchen Huang, Yukun Huang, Zili Lyu, Drew Lesniak, Parmjeet Randhawa
This study interrogates the antigen-specificity of inflammatory infiltrates in renal biopsies with BK polyomavirus (BKPyV) viremia (BKPyVM) with or without allograft nephropathy (BKPyVN). PBMC from 5 healthy HLA-A0101 subjects were stimulated by peptides derived from the BKPYV proteome or polymorphic regions of HLA. Next generation sequencing (NGS) of the T-cell receptor (TCR) cDNA was performed on peptide stimulated PBMC and 23 biopsies with T-cell mediated rejection (TCMR) or BKPyVN. Biopsies from patients with BKPyVM or BKVPyVN contained 7...
June 7, 2016: American Journal of Transplantation
H F Wunderink, E van der Meijden, C S van der Blij-de Brouwer, M J K Mallat, G W Haasnoot, E W van Zwet, E C J Claas, J W de Fijter, A C M Kroes, F Arnold, A Touzé, F H J Claas, J I Rotmans, M C W Feltkamp
Kidney transplant donors are currently not implicated in predicting BK polyomavirus (BKPyV) infection in kidney transplant recipients. It has been postulated, however, that BKPyV infection originates from the kidney allograft. Since BKPyV-seroreactivity correlates with BKPyV-replication and, therefore, 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 one year posttransplantation...
June 2, 2016: American Journal of Transplantation
Sandy Liu, Muhammad R Chaudhry, Alexander A Berrebi, John C Papadimitriou, Cinthia B Drachenberg, Abdolreza Haririan, Borislav A Alexiev
BACKGROUND: Solid organ transplant recipients are at increased risk for developing malignancies. Polyomaviruses (PV) have been historically associated with experimental tumor development and recently described in association with renourinary malignancies in transplant patients. The aim of this study was to investigate the relationship between PV replication and smoking, and the development of malignant neoplasms in kidney transplant recipients. METHODS: A retrospective case-control study was conducted for PV replication in all kidney biopsies and urine cytologies performed between 1998 and 2014 from kidney transplant recipients at the University of Maryland Medical Center...
May 26, 2016: Transplantation
M El Ansary, S Abd Elhamid, G Saadi, W Ismail, N Ibrahim, N Bahaa El-Din, S Alhsyek
BACKGROUND: Polyomavirus nephropathy (PVN) mainly caused by BK polyomavirus (BKPyV) remains the most common productive viral infection of the kidney in immunosuppressed patients. The diagnosis of PVN is based on the detection of BK viruria and BK viremia in conjunction with histological findings in the graft biopsy. METHODS: Our study was aimed to estimate the prevalence of productive BKPyV infection among renal transplant patients within the first year post-transplant and identify those at risk of developing PVN...
August 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Tu-Run Song, Zheng-Sheng Rao, Yang Qiu, Jin-Peng Liu, Zhong-Li Huang, Xian-Ding Wang, Tao Lin
Previous studies regarding the prevention of BK viremia following renal transplantation with fluoroquinolone have yielded conflicting results. The purpose of this systematic review was to examine the evidence regarding the efficacy of fluoroquinolone in preventing BK polyomavirus infection following renal transplantation. We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials for research articles published prior to January 2015 using keywords such as "fluoroquinolone," "BK viremia," and "renal transplantation...
March 2016: Kaohsiung Journal of Medical Sciences
C S Bicalho, R R Oliveira, L C Pierrotti, M C D S Fink, P R P Urbano, L H S Nali, E J A Luna, C M Romano, D R David, E David-Neto, C S Pannuti
BK virus-(BKV) associated nephropathy (BKVN) is a major cause of allograft injury in kidney transplant recipients. In such patients, subclinical reactivation of latent BKV infection can occur in the pre-transplant period. The purpose of this study was to determine whether urinary BKV shedding in the immediate pre-transplant period is associated with a higher incidence of viruria and viremia during the first year after kidney transplantation. We examined urine samples from 34 kidney transplant recipients, using real-time quantitative polymerase chain reaction to detect BKV...
July 2016: Clinical Transplantation
Marine Lebreton, Laure Esposito, Catherine Mengelle, Arnaud Del Bello, Antoine Delarche, Gaëlle Dörr, David Milongo, Olivier Marion, Jacques Izopet, Nassim Kamar
BACKGROUND: In vitro and retrospective studies of kidney-transplant patients have shown that quinolones can efficiently prevent BK virus (BKV) replication. However, in a prospective study, a 3 month-course of levofloxacin did not decrease the rate of BK viruria in kidney-transplant patients treated with standard immunosuppression. OBJECTIVES: The aim of this study was to assess the effect of a 3-month course of ciprofloxacin prophylaxis on BKV replication in kidney-transplant patients that had received heavy immunosuppression (plasma exchange or immunoadsorption and rituximab) to achieve desensitization before undergoing HLA- and/or ABO-incompatible (ABOi) transplantation...
June 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
W James Chon, Amishi Desai, Coady Wing, Divya Arwindekar, Ignatius Y S Tang, Michelle A Josephson, Sanjeev Akkina
BACKGROUND: Rapid steroid withdrawal (RSW) is used increasingly in kidney transplantation but long-term outcomes in African-American (AA) recipients are not well known. We compared 1 and 5 year transplant outcomes in a large cohort of AA patients who were maintained on continued steroid therapy (CST) to those who underwent RSW. METHODS: Post-transplant courses of A as receiving kidney allografts from 2003-2011 at two urban transplant centers in Chicago were followed...
2016: International Journal of Clinical Medicine
Hannelore Sprenger-Mähr, Emanuel Zitt, Afschin Soleiman, Karl Lhotta
Recurrent focal segmental glomerulosclerosis (FSGS) after renal transplantation is difficult to treat. Recently a series of four patients unresponsive to plasma exchange (PE) and rituximab, who were successfully treated with abatacept, has been reported. We present a 26-year-old Caucasian patient who suffered from juvenile rheumatoid arthritis and developed severe proteinuria eleven days after transplantation. An allograft biopsy was suggestive of recurrent focal segmental glomerulosclerosis. He did not respond to PE therapy...
2016: Case Reports in Transplantation
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