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Conversion to mTOR-Inhibitors Plus IV Immunoglobulins in Kidney-Transplant Recipients with BKV Infection: A Retrospective Comparative Study
BK virus-associated nephropathy (PvAN) increases the risk of graft failure justifying treatment. Conversion to mammalian target of rapamycin inhibitors (mTORi) and Human polyclonal immunoglobulins (IVIg) could prevent the risk of PvAN. Our retrospective study assessed the efficacy of mTORi associate...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9785214/ https://www.ncbi.nlm.nih.gov/pubmed/36555909 http://dx.doi.org/10.3390/jcm11247292 |
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author | Vela, Carla Jouve, Thomas Chevallier, Eloi Imerzoukene, Farida Germi, Raphaële Le Marechal, Marion Truffot, Aurélie Fiard, Gaëlle Janbon, Bénédicte Giovannini, Diane Malvezzi, Paolo Rostaing, Lionel Noble, Johan |
author_facet | Vela, Carla Jouve, Thomas Chevallier, Eloi Imerzoukene, Farida Germi, Raphaële Le Marechal, Marion Truffot, Aurélie Fiard, Gaëlle Janbon, Bénédicte Giovannini, Diane Malvezzi, Paolo Rostaing, Lionel Noble, Johan |
author_sort | Vela, Carla |
collection | PubMed |
description | BK virus-associated nephropathy (PvAN) increases the risk of graft failure justifying treatment. Conversion to mammalian target of rapamycin inhibitors (mTORi) and Human polyclonal immunoglobulins (IVIg) could prevent the risk of PvAN. Our retrospective study assessed the efficacy of mTORi associated with IVIg therapy (mTORi±IVIg group) versus standard immunosuppression reduction to clear BKV DNAemia. Among forty-three kidney-transplanted patients with positive BKV DNAemia, we included twenty-six patients in the mTORi±IVIg group and reduced immunosuppression therapy for seventeen patients. We focused on BKV DNAemia clearance on the first-year. Renal function, rejection rate, evolution to PvAN, and complications of immunosuppression were assessed. BKV DNAemia decreased faster and significantly in the control group as compared to the mTORi±IVIg group (p < 0.001). Viral clearance was significantly higher in the control group compared to the mTORi±IVIg group (88% vs. 58%; p = 0.033). Death-censored graft loss, rejection rates and kidney-graft function at 12 months did not significantly differ. Multivariate analyses significantly associated BKV DNAemia clearance with reducing immunosuppression (OR = 0.11 (0.06–0.9), p = 0.045), female kidney donor (OR = 0.10 (0.01–0.59/)], p = 0.018) and time to first DNAemia, (OR = 0.88 (0.76–0.96), p = 0.019). In our study, the standard treatment for BKV DNAemia had better outcomes than an mTORi±IVIg conversion. |
format | Online Article Text |
id | pubmed-9785214 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-97852142022-12-24 Conversion to mTOR-Inhibitors Plus IV Immunoglobulins in Kidney-Transplant Recipients with BKV Infection: A Retrospective Comparative Study Vela, Carla Jouve, Thomas Chevallier, Eloi Imerzoukene, Farida Germi, Raphaële Le Marechal, Marion Truffot, Aurélie Fiard, Gaëlle Janbon, Bénédicte Giovannini, Diane Malvezzi, Paolo Rostaing, Lionel Noble, Johan J Clin Med Article BK virus-associated nephropathy (PvAN) increases the risk of graft failure justifying treatment. Conversion to mammalian target of rapamycin inhibitors (mTORi) and Human polyclonal immunoglobulins (IVIg) could prevent the risk of PvAN. Our retrospective study assessed the efficacy of mTORi associated with IVIg therapy (mTORi±IVIg group) versus standard immunosuppression reduction to clear BKV DNAemia. Among forty-three kidney-transplanted patients with positive BKV DNAemia, we included twenty-six patients in the mTORi±IVIg group and reduced immunosuppression therapy for seventeen patients. We focused on BKV DNAemia clearance on the first-year. Renal function, rejection rate, evolution to PvAN, and complications of immunosuppression were assessed. BKV DNAemia decreased faster and significantly in the control group as compared to the mTORi±IVIg group (p < 0.001). Viral clearance was significantly higher in the control group compared to the mTORi±IVIg group (88% vs. 58%; p = 0.033). Death-censored graft loss, rejection rates and kidney-graft function at 12 months did not significantly differ. Multivariate analyses significantly associated BKV DNAemia clearance with reducing immunosuppression (OR = 0.11 (0.06–0.9), p = 0.045), female kidney donor (OR = 0.10 (0.01–0.59/)], p = 0.018) and time to first DNAemia, (OR = 0.88 (0.76–0.96), p = 0.019). In our study, the standard treatment for BKV DNAemia had better outcomes than an mTORi±IVIg conversion. MDPI 2022-12-08 /pmc/articles/PMC9785214/ /pubmed/36555909 http://dx.doi.org/10.3390/jcm11247292 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Vela, Carla Jouve, Thomas Chevallier, Eloi Imerzoukene, Farida Germi, Raphaële Le Marechal, Marion Truffot, Aurélie Fiard, Gaëlle Janbon, Bénédicte Giovannini, Diane Malvezzi, Paolo Rostaing, Lionel Noble, Johan Conversion to mTOR-Inhibitors Plus IV Immunoglobulins in Kidney-Transplant Recipients with BKV Infection: A Retrospective Comparative Study |
title | Conversion to mTOR-Inhibitors Plus IV Immunoglobulins in Kidney-Transplant Recipients with BKV Infection: A Retrospective Comparative Study |
title_full | Conversion to mTOR-Inhibitors Plus IV Immunoglobulins in Kidney-Transplant Recipients with BKV Infection: A Retrospective Comparative Study |
title_fullStr | Conversion to mTOR-Inhibitors Plus IV Immunoglobulins in Kidney-Transplant Recipients with BKV Infection: A Retrospective Comparative Study |
title_full_unstemmed | Conversion to mTOR-Inhibitors Plus IV Immunoglobulins in Kidney-Transplant Recipients with BKV Infection: A Retrospective Comparative Study |
title_short | Conversion to mTOR-Inhibitors Plus IV Immunoglobulins in Kidney-Transplant Recipients with BKV Infection: A Retrospective Comparative Study |
title_sort | conversion to mtor-inhibitors plus iv immunoglobulins in kidney-transplant recipients with bkv infection: a retrospective comparative study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9785214/ https://www.ncbi.nlm.nih.gov/pubmed/36555909 http://dx.doi.org/10.3390/jcm11247292 |
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