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BK viremia

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https://www.readbyqxmd.com/read/28030755/epidemiology-of-infections-following-haploidentical-peripheral-blood-hematopoietic-cell-transplantation
#1
Michael Slade, Scott Goldsmith, Rizwan Romee, John F DiPersio, Erik R Dubberke, Peter Westervelt, Geoffrey L Uy, Steven J Lawrence
BACKGROUND: The use of T-cell replete haploidentical hematopoietic cell transplant (haplo-HCT) has increased substantially since the introduction of post-transplant cyclophosphamide (PTCy) regimens. Limited data exist concerning infectious complications of haplo-HCT utilizing mobilized peripheral blood (PB) hematopoietic cells. METHODS: This retrospective cohort study included all adult patients at our institution undergoing PB haplo-HCT with PTCy between June 2009 and June 2015...
November 7, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28019062/complete-resolution-of-trichodysplasia-spinulosa-in-a-pediatric-renal-transplant-patient-case-report-and-literature-review
#2
Lauren P Coogle, Kristen E Holland, Cynthia Pan, Scott K Van Why
TS of immunosuppression is a rare, disfiguring dermatologic condition caused by TS-associated polyomavirus in immunosuppressed patients. It is difficult to treat, with no clearly described approach to resolve the condition completely and safely. We report a child with a renal transplant who developed TS and was treated with significant reduction in immunosuppression and transient use of cidofovir cream. The combined approach, primarily with significant long-term reduction in immunosuppression guided by monitoring BK viremia in our patient, led to complete resolution of TS without recurrence or graft rejection by 5 years after transplant...
December 25, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27989013/relationship-between-viremia-viral-infection-alloimmunity-and-nutritional-parameters-in-the-first-year-after-pediatric-kidney-transplantation
#3
Robert Ettenger, Hyunsook Chin, Karen Kesler, Nancy Bridges, Paul Grimm, Elaine F Reed, Minnie Sarwal, Richard Sibley, Eileen Tsai, Barry Warshaw, Allan D Kirk
The Immune Development in Pediatric Transplantation (IMPACT) study was conducted to evaluate relationships between alloimmunity, protective immunity, immune development, physical parameters and clinical outcome in children undergoing kidney transplantation. We prospectively evaluated biopsy-proven acute rejection (BPAR), de novo donor specific antibody (dnDSA) formation, viremia, viral infection, T cell immunophenotyping and BMI/weight Z scores in the first year post-transplant in 106 pediatric kidney transplant recipients...
December 18, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27941433/kidney-fibrosis-origins-and-interventions
#4
Thomas Vanhove, Roel Goldschmeding, Dirk Kuypers
All causes of renal allograft injury, when severe and/or sustained, can result in chronic histological damage of which interstitial fibrosis and tubular atrophy (IF/TA) are dominant features. Unless a specific disease process can be identified, what drives IF/TA progression in individual patients is often unclear. In general, clinicopathological factors known to predict and drive allograft fibrosis include graft quality, inflammation (whether 'nonspecific' or related to a specific diagnosis), infections such as polyomavirus-associated nephropathy, calcineurin inhibitors and genetic factors...
December 8, 2016: Transplantation
https://www.readbyqxmd.com/read/27925350/a-kidney-transplant-recipient-with-renal-medullary-viral-cytopathic-changes
#5
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
#6
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
#7
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 whether 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 1 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
#8
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
#9
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
#10
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
#11
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
#12
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 analyze clinical outcomes and the risk factors associated with genitourinary (GU) morbidity and mortality in children who present with hemorrhagic cystitis (HC) after bone marrow transplant (BMT). METHODS: A retrospective chart review of patients with HC who had undergone BMT at a single pediatric hospital from 2008 to 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
#13
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
#14
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...
December 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
#15
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-polyomavirus-infection-after-kidney-transplantation-is-independent-of-type-of-immunosuppressive-therapy
#16
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)...
December 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
#17
Hyosang Kim, Hoon Yu, Chung Hee Baek, Duck Jong Han, Su-Kil 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 BK polyomavirus nephropathy, 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...
December 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
#18
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
#19
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
#20
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
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