TY - JOUR
T1 - Treatment for BK virus
T2 - Incidence, risk factors and outcomes for kidney transplant recipients in the United States
AU - Schold, Jesse D.
AU - Rehman, Shezhad
AU - Kayler, Liise K.
AU - Magliocca, Joseph
AU - Srinivas, Titte R.
AU - Meier-Kriesche, Herwig Ulf
PY - 2009/6
Y1 - 2009/6
N2 - There has been a notable rise of BK virus among kidney transplant recipients. Single-center reports have identified risk factors for development of BK virus. However, there has not been an assessment of risk factors and incidence of this complication at a national level. This study utilized newly collected follow-up information from the national SRTR database to investigate incidence, risk factors and outcomes for solitary kidney transplant recipients associated with treatment for BK virus (TBKV) from 2004 to 2006. Logistic and Cox models were utilized to assess risk factors and evaluate graft survival associated with TBKV. Incidence of TBKV was 1.6% at 6 months and 2.6% at 1 year following transplantation. Patients with and without TBKV at 6 months had 79% and 90% 3-year overall graft survival respectively. Risk factors included advanced donor age, pediatric, African American and male recipients, human leukocyte antigen-mismatching and tacrolimus and thymoglobulin induction as baseline immunosuppression. Acute rejection episodes were more frequent prior to and following TBKV. TBKV is a common and rising incidence, varies based on transplant characteristics and should be included as a safety endpoint in studies investigating immunosuppressive protocols. Careful monitoring and further understanding of disease etiology and treatment strategies are needed.
AB - There has been a notable rise of BK virus among kidney transplant recipients. Single-center reports have identified risk factors for development of BK virus. However, there has not been an assessment of risk factors and incidence of this complication at a national level. This study utilized newly collected follow-up information from the national SRTR database to investigate incidence, risk factors and outcomes for solitary kidney transplant recipients associated with treatment for BK virus (TBKV) from 2004 to 2006. Logistic and Cox models were utilized to assess risk factors and evaluate graft survival associated with TBKV. Incidence of TBKV was 1.6% at 6 months and 2.6% at 1 year following transplantation. Patients with and without TBKV at 6 months had 79% and 90% 3-year overall graft survival respectively. Risk factors included advanced donor age, pediatric, African American and male recipients, human leukocyte antigen-mismatching and tacrolimus and thymoglobulin induction as baseline immunosuppression. Acute rejection episodes were more frequent prior to and following TBKV. TBKV is a common and rising incidence, varies based on transplant characteristics and should be included as a safety endpoint in studies investigating immunosuppressive protocols. Careful monitoring and further understanding of disease etiology and treatment strategies are needed.
KW - BK virus nephropathy
KW - Graft survival
KW - Kidney transplantation
KW - Polyoma virus
KW - Post-transplant complications
UR - http://www.scopus.com/inward/record.url?scp=65549095916&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=65549095916&partnerID=8YFLogxK
U2 - 10.1111/j.1432-2277.2009.00842.x
DO - 10.1111/j.1432-2277.2009.00842.x
M3 - Article
C2 - 19207187
AN - SCOPUS:65549095916
SN - 0934-0874
VL - 22
SP - 626
EP - 634
JO - Transplant International
JF - Transplant International
IS - 6
ER -