Hoecker, Britta, Schneble, Lukas, Murer, Luisa, Carraro, Andrea ORCID: 0000-0001-9564-9491, Pape, Lars, Kranz, Birgitta, Oh, Jun, Zirngibl, Matthias, Dello Strologo, Luca, Buescher, Anja, Weber, Lutz T., Awan, Atif, Pohl, Martin, Bald, Martin, Printza, Nikoleta, Rusai, Krisztina, Peruzzi, Licia, Topaloglu, Rezan, Fichtner, Alexander, Krupka, Kai, Koester, Lennart, Bruckner, Thomas, Schnitzler, Paul, Hirsch, Hans H. ORCID: 0000-0003-0883-0423 and Toenshoff, Burkhard (2019). Epidemiology of and Risk Factors for BK Polyomavirus Replication and Nephropathy in Pediatric Renal Transplant Recipients: An International CERTAIN Registry Study. Transplantation, 103 (6). S. 1224 - 1234. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1534-6080

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Abstract

Background. BK polyomavirus-associated nephropathy (BKPyVAN) constitutes a serious cause of kidney allograft failure, but large-scale data in pediatric renal transplant recipients and a comprehensive analysis of specific risk factors are lacking. Methods. We analyzed the data of 313 patients in the Cooperative European Pediatric Renal Transplant Initiative Registry, with an observation period of 3.3 years (range, 1-5). The net state of immunosuppressive therapy was assessed by the modified Vasudev score. Results. Presumptive BKPyVAN (defined as sustained [>3 wk] high-level BK viremia >10(4) copies/mL) within 5 years posttransplant occurred in 49 (15.8%) of 311 patients, and biopsy-proven BKPyVAN in 14 (4.5%) of 313. BKPyV viremia was observed in 115 (36.7%) of 311 patients, of whom 11 (9.6%) of 115 developed viremia late, that is, after the second year posttransplant. In 6 (12.5%) of 48 patients with high-level viremia and in 3 (21.4%) of 14 with BKPyVAN, this respective event occurred late. According to multivariable analysis, BKPyV viremia and/or BKPyVAN were associated not only with a higher net state of immunosuppression (odds ratio [OR], 1.3; P < 0.01) and with tacrolimus-based versus ciclosporin-based immunosuppression (OR, 3.6; P < 0.01) but also with younger recipient age (OR, 1.1 per y younger; P < 0.001) and obstructive uropathy (OR, 12.4; P < 0.01) as primary renal disease. Conclusions. Uncontrolled BKPyV replication affects a significant proportion of pediatric renal transplant recipients and is associated with unique features of epidemiology and risk factors, such as young recipient age, obstructive uropathy, and overall intensity of immunosuppressive therapy. BKPyV surveillance should be considered beyond 2 years posttransplant in pediatric patients at higher risk.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Hoecker, BrittaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schneble, LukasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Murer, LuisaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Carraro, AndreaUNSPECIFIEDorcid.org/0000-0001-9564-9491UNSPECIFIED
Pape, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kranz, BirgittaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Oh, JunUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zirngibl, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dello Strologo, LucaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Buescher, AnjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weber, Lutz T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Awan, AtifUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pohl, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bald, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Printza, NikoletaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rusai, KrisztinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Peruzzi, LiciaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Topaloglu, RezanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fichtner, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krupka, KaiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Koester, LennartUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bruckner, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schnitzler, PaulUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hirsch, Hans H.UNSPECIFIEDorcid.org/0000-0003-0883-0423UNSPECIFIED
Toenshoff, BurkhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-138448
DOI: 10.1097/TP.0000000000002414
Journal or Publication Title: Transplantation
Volume: 103
Number: 6
Page Range: S. 1224 - 1234
Date: 2019
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Place of Publication: PHILADELPHIA
ISSN: 1534-6080
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
URETERAL STENT PLACEMENT; VIRUS-INFECTION; OBSTRUCTIVE UROPATHY; ALLOGRAFT RECIPIENTS; RESEARCH PLATFORM; IN-VIVO; KIDNEY; ANTIBODY; IMPACT; CYTOMEGALOVIRUSMultiple languages
Immunology; Surgery; TransplantationMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/13844

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