Human leukocyte antigen Cw7-mediated protection against polyoma BK virus in renal transplant recipients who received grafts from antigen-positive donors.

OBJECTIVES: Nephropathy from BK virus is an increasing problem in renal transplant recipients and has been correlated with newer immunosuppressive agents and the decline in acute rejection rates. We aimed to evaluate the effect of BK virus-positive kidney donors on the outcome of kidney transplant recipients after mean follow-up 21 months.

MATERIALS AND METHODS: Among 18 kidney donors with BK virus in blood and urine, 5 donors were fit for donation. Clinical information was reviewed for the 5 kidney transplant recipients who received kidney allografts from these donors (mean donor age, 35 ± 3 y).

RESULTS: All recipients except 1 were women (mean age, 49.4 ± 4.2 y; body weight, 68.2 ± 4 kg, followup, 21.6 ± 4 mo). All patients except 1 received antithymocyte globulin induction, and all 5 patients received steroids, tacrolimus, and mycophenolate mofetil as maintenance therapy. Ureter stenting was a routine procedure in each case. Human leukocyte antigen Cw7 was detected in 4 of 5 recipients, and the fifth case, the antigen was detected in the donor. At last follow-up, all patients were enjoying functioning grafts without recurrence of BK virus infection.

CONCLUSIONS: Polyoma BK virus-positive people can be accepted safely for kidney donation, especially with a possible protective role of human leukocyte antigen Cw7.