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BK viremia and polyomavirus nephropathy in 352 kidney transplants; risk factors and potential role of mTOR inhibition

BACKGROUND: Polyomavirus BK nephropathy (PyVAN) remains an important cause of early graft dysfunction and graft loss in kidney transplantation. METHODS: In this retrospective, single centre cohort study we studied the incidence and outcome of BK viral infection in 352 patients transplanted in 2008–2...

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Autores principales: Jacobi, Johannes, Prignitz, Antonina, Büttner, Maike, Korn, Klaus, Weidemann, Alexander, Hilgers, Karl F, Heller, Katharina, Velden, Joachim, Knöll, Antje, Wullich, Bernd, May, Christoph, Eckardt, Kai-Uwe, Amann, Kerstin U
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3850699/
https://www.ncbi.nlm.nih.gov/pubmed/24088187
http://dx.doi.org/10.1186/1471-2369-14-207
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author Jacobi, Johannes
Prignitz, Antonina
Büttner, Maike
Korn, Klaus
Weidemann, Alexander
Hilgers, Karl F
Heller, Katharina
Velden, Joachim
Knöll, Antje
Wullich, Bernd
May, Christoph
Eckardt, Kai-Uwe
Amann, Kerstin U
author_facet Jacobi, Johannes
Prignitz, Antonina
Büttner, Maike
Korn, Klaus
Weidemann, Alexander
Hilgers, Karl F
Heller, Katharina
Velden, Joachim
Knöll, Antje
Wullich, Bernd
May, Christoph
Eckardt, Kai-Uwe
Amann, Kerstin U
author_sort Jacobi, Johannes
collection PubMed
description BACKGROUND: Polyomavirus BK nephropathy (PyVAN) remains an important cause of early graft dysfunction and graft loss in kidney transplantation. METHODS: In this retrospective, single centre cohort study we studied the incidence and outcome of BK viral infection in 352 patients transplanted in 2008–2011. RESULTS: During follow-up viral replication was detected in 48 patients (13.6%); 22 patients (6.2%) had biopsy proven PyVAN. In multivariate logistic regression analyses risk factors for BK-viremia were lack of enrolment into randomized controlled trials (RCTs), biopsy proven acute rejections, cytomegaly virus (CMV) serostatus of both donor and recipient and previous transplantation. In patients without PyVAN reduction or switch of immunosuppression was associated with rapid viral clearance and stable graft function. In contrast, in most patients with PyVAN graft function deteriorated and 5 patients prematurely lost their allograft. Switch of immunosuppression to a low dose cyclosporine plus mTOR inhibitor based regimen in patients with PyVAN was safe, well tolerated and tended to be associated with a better short-term outcome in terms of graft function compared to reduction of existing immunosuppression alone. CONCLUSIONS: With the lack of licensed anti-polyoma viral drugs reduction or conversion of immunosuppression remains the mainstay of therapy in patients with PyVAN. The combination of low dose cyclosporine plus mTOR inhibition appears to be safe and warrants further investigation.
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spelling pubmed-38506992013-12-05 BK viremia and polyomavirus nephropathy in 352 kidney transplants; risk factors and potential role of mTOR inhibition Jacobi, Johannes Prignitz, Antonina Büttner, Maike Korn, Klaus Weidemann, Alexander Hilgers, Karl F Heller, Katharina Velden, Joachim Knöll, Antje Wullich, Bernd May, Christoph Eckardt, Kai-Uwe Amann, Kerstin U BMC Nephrol Research Article BACKGROUND: Polyomavirus BK nephropathy (PyVAN) remains an important cause of early graft dysfunction and graft loss in kidney transplantation. METHODS: In this retrospective, single centre cohort study we studied the incidence and outcome of BK viral infection in 352 patients transplanted in 2008–2011. RESULTS: During follow-up viral replication was detected in 48 patients (13.6%); 22 patients (6.2%) had biopsy proven PyVAN. In multivariate logistic regression analyses risk factors for BK-viremia were lack of enrolment into randomized controlled trials (RCTs), biopsy proven acute rejections, cytomegaly virus (CMV) serostatus of both donor and recipient and previous transplantation. In patients without PyVAN reduction or switch of immunosuppression was associated with rapid viral clearance and stable graft function. In contrast, in most patients with PyVAN graft function deteriorated and 5 patients prematurely lost their allograft. Switch of immunosuppression to a low dose cyclosporine plus mTOR inhibitor based regimen in patients with PyVAN was safe, well tolerated and tended to be associated with a better short-term outcome in terms of graft function compared to reduction of existing immunosuppression alone. CONCLUSIONS: With the lack of licensed anti-polyoma viral drugs reduction or conversion of immunosuppression remains the mainstay of therapy in patients with PyVAN. The combination of low dose cyclosporine plus mTOR inhibition appears to be safe and warrants further investigation. BioMed Central 2013-10-02 /pmc/articles/PMC3850699/ /pubmed/24088187 http://dx.doi.org/10.1186/1471-2369-14-207 Text en Copyright © 2013 Jacobi et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Jacobi, Johannes
Prignitz, Antonina
Büttner, Maike
Korn, Klaus
Weidemann, Alexander
Hilgers, Karl F
Heller, Katharina
Velden, Joachim
Knöll, Antje
Wullich, Bernd
May, Christoph
Eckardt, Kai-Uwe
Amann, Kerstin U
BK viremia and polyomavirus nephropathy in 352 kidney transplants; risk factors and potential role of mTOR inhibition
title BK viremia and polyomavirus nephropathy in 352 kidney transplants; risk factors and potential role of mTOR inhibition
title_full BK viremia and polyomavirus nephropathy in 352 kidney transplants; risk factors and potential role of mTOR inhibition
title_fullStr BK viremia and polyomavirus nephropathy in 352 kidney transplants; risk factors and potential role of mTOR inhibition
title_full_unstemmed BK viremia and polyomavirus nephropathy in 352 kidney transplants; risk factors and potential role of mTOR inhibition
title_short BK viremia and polyomavirus nephropathy in 352 kidney transplants; risk factors and potential role of mTOR inhibition
title_sort bk viremia and polyomavirus nephropathy in 352 kidney transplants; risk factors and potential role of mtor inhibition
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3850699/
https://www.ncbi.nlm.nih.gov/pubmed/24088187
http://dx.doi.org/10.1186/1471-2369-14-207
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