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BK viremia

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https://www.readbyqxmd.com/read/27925350/a-kidney-transplant-recipient-with-renal-medullary-viral-cytopathic-changes
#1
Poornima Ramanan, Elizabeth A Timmerman, Mary E Fidler, Hatem Amer, Bobbi S Pritt, Dale A Schwab, Hollis J Batterman, Matthew J Binnicker
We present a case of JC polyomavirus (JCV)-associated nephropathy (PyVAN) in an asymptomatic deceased-donor kidney transplant recipient. Despite the presence of viral cytopathic effect in the kidney biopsy and positive BK polyomavirus (BKV) in situ hybridization (ISH), BKV real-time polymerase chain reaction (PCR) results of plasma and urine were negative. JCV ISH was performed and was found to be positive. JCV real-time PCR on urine, plasma, and the kidney biopsy tissue was positive. Reduction in immunosuppression resulted in resolution of JCV viremia...
December 7, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27910187/ureteral-stent-duration-and-the-risk-of-bk-polyomavirus-viremia-or-bacteriuria-after-kidney-transplantation
#2
Jonathan T Wingate, Jared Brandenberger, Andrew Weiss, Lauren G Scovel, Christian S Kuhr
OBJECTIVES: Ureteral stents are used in kidney transplantation (KTX) to decrease post-operative complications, but are associated with BK polyomavirus viremia (BKV). Our primary outcome was to determine the association between ureteral stent duration and BKV. Secondary outcome measures were the association between bacteriuria and stent duration or use of ureteral stent strings. METHODS: Between January 2010 and January 2015, 403 patients underwent KTX at Virginia Mason Medical Center and met inclusion criteria...
December 2, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27862417/ureteral-stent-placement-and-immediate-graft-function-are-associated-with-increased-risk-of-bk-viremia-in-the-first-year-after-kidney-transplantation
#3
Joseph G Maliakkal, Daniel C Brennan, Charles Goss, Timothy A Horwedel, Howard Chen, Dennis K Fong, Nikhil Agarwal, Jie Zheng, Kenneth B Schechtman, Vikas R Dharnidharka
Ureteral stent (UrSt) placement has been shown to be a significant independent risk factor for BK viruria, viremia and BK virus nephropathy. We assessed if this observation could be validated at our high volume kidney transplant center that has had a strong historical focus on BK virus nephropathy detection. We performed a retrospective case-control study of adults receiving a kidney-only transplant and followed for one year between 2004 and 2011 with uniform immunosuppression and use of blood BK virus PCR screening protocol...
November 18, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27854236/correlation-of-bk-virus-neutralizing-serostatus-with-the-incidence-of-bk-viremia-in-kidney-transplant-recipients
#4
Johanna R Abend, Marguerite Changala, Atul Sathe, Fergal Casey, Amy Kistler, Sindhu Chandran, Abigail Howard, David Wojciechowski
BACKGROUND: BK virus (BKV)-associated nephropathy is the second leading cause of graft loss in kidney transplant recipients. Due to the high prevalence of persistent infection with BKV in the general population, it is possible that either the transplant recipient or donor may act as the source of virus resulting in viruria and viremia. Although several studies suggest a correlation between donor-recipient serostatus and the development of BK viremia, specific risk factors for BKV-related complications in the transplant setting remain to be established...
June 1, 2016: Transplantation
https://www.readbyqxmd.com/read/27821629/polyomavirus-reactivation-and-immune-responses-to-kidney-specific-self-antigens-in-transplantation
#5
Michael E Seifert, Muthukumar Gunasekaran, Timothy A Horwedel, Reem Daloul, Gregory A Storch, Thalachallour Mohanakumar, Daniel C Brennan
Humoral immune responses against donor antigens are important determinants of long-term transplant outcomes. Reactivation of the polyomavirus BK has been associated with de novo antibodies against mismatched donor HLA antigens in kidney transplantation. The effect of polyomavirus reactivation (BK viremia or JC viruria) on antibodies to kidney-specific self-antigens is unknown. We previously reported excellent 5-year outcomes after minimization of immunosuppression for BK viremia and after no intervention for JC viruria...
November 7, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27799969/bk-viremia-among-iranian-renal-transplant-candidates
#6
Manizheh Jozpanahi, Amitis Ramezani, Shahrzad Ossareh, Mohammad Banifazl, Anahita Bavand, Setareh Mamishi, Arezoo Aghakhani
BACKGROUND: Primary infection with BK virus (BKV) is occurred during childhood and usually asymptomatic, but after initial infection, BKV may persist lifelong in the kidney and genitourinary tract. Reactivation may occur in individuals with compromised immunity such as renal transplant recipients. Due to the role of BKV in BK virus-associated nephropathy (BKVAN) and potentially renal allograft rejection, the detection of BKV in renal transplant candidates is very important. The aim of this study was to evaluate the frequency of BK viremia in end stage renal disease cases who were candidates for renal transplantation...
2016: Iranian Journal of Pathology
https://www.readbyqxmd.com/read/27798510/infections-in-de-novo-kidney-transplant-recipients-treated-with-the-rankl-inhibitor-denosumab
#7
Marco Bonani, Diana Frey, Olivier de Rougemont, Nicolas J Mueller, Thomas F Mueller, Nicole Graf, Rudolf P Wüthrich
BACKGROUND: Infections are a major cause of morbidity and mortality in kidney allograft recipients. In this posthoc analysis of a randomized clinical trial which tested the effect of denosumab on bone mineral density we assessed the impact of this drug on the incidence and severity of infections in the first year after kidney transplantation. METHODS: In this clinical trial we randomized 90 de novo kidney transplant recipients shortly after transplantation to either denosumab on top of standard treatment (calcium and vitamin D) (n=46), or to standard treatment alone (n=44)...
October 28, 2016: Transplantation
https://www.readbyqxmd.com/read/27793653/urologic-outcomes-of-children-with-hemorrhagic-cystitis-after-bone-marrow-transplant-at-a-single-institution
#8
Jason K Au, Christopher Graziano, Rodolfo A Elizondo, Sheila Ryan, David R Roth, Chester J Koh, Edmond T Gonzales, Duong T Tu, Nicolette Janzen, Swati Naik, Abhishek Seth
OBJECTIVE: To analyzed clinical outcomes and the risk factors associated with genitourinary (GU) morbidity and mortality in children who present with Hemorrhagic Cystitis (HC) after bone marrow transplantation (BMT). METHODS: A retrospective chart review of patients with HC who had undergone BMT at a single pediatric hospital from 2008-2015 was conducted. Demographic data, severity of hematuria, HC management, and mortality were analyzed. Bivariate analysis and binary logistic regression were performed to identify risk factors...
October 25, 2016: Urology
https://www.readbyqxmd.com/read/27762478/bk-polyomavirus-infection-in-pediatric-heart-transplant-recipients-a-prospective-study
#9
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
https://www.readbyqxmd.com/read/27717279/successful-renal-retransplantation-after-graft-loss-from-bk-polyomavirus-infection-in-a-human-immunodeficiency-virus-positive-patient
#10
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
https://www.readbyqxmd.com/read/27668162/high-level-viruria-as-a-screening-tool-for-bk-virus-nephropathy-in-renal-transplant-recipients
#11
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
https://www.readbyqxmd.com/read/27639176/incidence-of-bk-virus-infection-after-kidney-transplantation-is-independent-of-type-of-immunosuppressive-therapy
#12
Josephine Radtke, Nina Dietze, Lutz Fischer, Eike-Gert Achilles, Jun Li, Silke Scheidat, Friedrich Thaiss, Bjoern Nashan, Martina 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. 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)...
September 17, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27622599/high-dose-steroid-therapy-in-bk-viremia-adversely-affected-the-long-term-graft-function-after-kidney-transplantation
#13
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
https://www.readbyqxmd.com/read/27573493/influence-of-tacrolimus-metabolism-rate-on-bkv-infection-after-kidney-transplantation
#14
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
https://www.readbyqxmd.com/read/27496456/nephropathy-evolving-within-the-first-two-posttransplant-months-with-no-typical-cytopathic-lesions-two-cases-presentation
#15
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
https://www.readbyqxmd.com/read/27463537/immune-desensitization-allows-pediatric-blood-group-incompatible-kidney-transplantation
#16
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
https://www.readbyqxmd.com/read/27391197/increased-frequency-of-bk-virus-specific-polyfunctional-cd8-t-cells-predict-successful-control-of-bk-viremia-after-kidney-transplantation
#17
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
https://www.readbyqxmd.com/read/27342655/ultrasound-findings-of-bk-polyomavirus-associated-nephropathy-in-renal-transplant-patients
#18
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
https://www.readbyqxmd.com/read/27317859/bk-and-jc-virus-infections-in-healthy-patients-compared-to-kidney-transplant-recipients-in-tunisia
#19
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
https://www.readbyqxmd.com/read/27273900/antigen-specificity-of-t-cell-infiltrates-in-biopsies-with-t-cell-mediated-rejection-and-bk-polyomavirus-viremia-analysis-by-next-generation-sequencing
#20
G Zeng, Y Huang, Y Huang, Z Lyu, D Lesniak, P 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). Peripheral blood mononuclear cells (PBMC) from five healthy HLA-A0101 subjects were stimulated by peptides derived from the BKPYV proteome or polymorphic regions of HLA. Next generation sequencing of the T cell-receptor complementary DNA was performed on peptide-stimulated PBMC and 23 biopsies with T cell-mediated rejection (TCMR) or BKPyVN...
November 2016: American Journal of Transplantation
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