BK virus in renal transplant recipients.

Plaxton, S. (Shannon) (2013) BK virus in renal transplant recipients. thesis, Medicine.

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Abstract

Background: The incidence of BK virus (BKV) in renal transplant recipients has increased over the past few years, partly due to more potent immunosuppressive regimens. In 5-10% of all recipients, infection leads to BK virus-associated nephropathy (BKVAN), which frequently causes graft loss. The absence of treatment options emphasises the need for adequate monitoring and early intervention. Objectives: The objectives were threefold: 1) To provide an overview of the prevalence rates of BKV in renal transplant recipients in the University Medical Centre Groningen (UMCG), 2) to identify the patients at risk of developing BKVAN in the 2010 cohort, and 3) to recommend effective screening and intervention strategies. Study design: This is a retrospective cohort analysis of 128 renal transplant recipients transplanted in a period of one year at the UMCG. Urine and plasma samples of all patients were collected at multiple time points post transplantation and screened for BKV. Patients were divided into four groups representing increasing intensity of infection and subsequently analysed for both viral parameters and clinical data. Results: BKV infections were relatively uncommon in our transplantation centre (16.3%). Acute rejection episodes in the first year after transplantation occurred significantly more often in patients with BKVAN, and a higher viral load of BKV in both urine and plasma was associated with the development of BKVAN. There was no difference in overall graft survival between the BKV positive and negative groups. Conclusions: BKVAN is an uncommon but serious complication of renal transplantations. Recommendations for optimal management strategies of BKV include intensive prospective monitoring of BK viral loads in urine and plasma, especially during the first six months after transplantation. This study offers a starting point for identifying patients at risk for BKVAN who may be candidates for pre-emptive therapy.

Item Type:	Thesis (Thesis)
Supervisor name:	Riezebos-Brilman, Dr. Annelies and Sanders, Dr. Jan-Stephan
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:50
Last Modified:	25 Jun 2020 10:50
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1074

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