Prevalence and risk factors of polyomavirus BK replication in simultaneous pancreas/kidney transplant recipients from a single transplant center.

BK virus (BKV) replication is considered as a marker of risk for polyomavirus BK-associated nephropathy (PVAN). We evaluated the occurrence and risk factors for BKV DNA positivity following simultaneous pancreas/kidney transplantation (SPK). Point prevalence of BK viruria and viremia was assessed in 183 SPK recipients. Real-time polymerase chain reaction was used with a detection threshold of 10(3) copies/mL. High-level BKV positivity was defined as viruria and/or viremia >10(7) and >10(4) copies/mL, respectively. BKV-positive patients were retested after 4-13 months and underwent an additional six-month clinical follow-up. Urine and serum BKV positivity was detected in 28 (17.3% of available samples) and 7 (3.8%) patients, with high-level viruria and viremia occurring in 6 (3.7%) and 3 (1.6%) patients, respectively. PVAN was biopsy-confirmed in 1 and suspected as a cause of progressive renal failure in another SPK recipient. Patients with single low-level viruria did not progress to high-level positivity or PVAN at follow-up. In multivariate analysis, pre-transplant diabetes duration and delayed graft function were independently associated with BKV positivity. Point prevalence of high-level BKV positivity and PVAN was low in SPK recipients from a single center. Diabetes duration and delayed graft function were independent risk factors for BKV replication.

Mindlova M ，Boucek P ，Saudek F ，Skibova J ，Jedinakova T ，Lipar K ，Adamec M ，Hirsch HH ... -  《-》

Sustained BK viruria as an early marker for the development of BKV-associated nephropathy: analysis of 4128 urine and serum samples.

Babel N ，Fendt J ，Karaivanov S ，Bold G ，Arnold S ，Sefrin A ，Lieske E ，Hoffzimmer M ，Dziubianau M ，Bethke N ，Meisel C ，Grütz G ，Reinke P ... -  《-》

Polyomavirus polymerase chain reaction as a surrogate marker of polyomavirus-associated nephropathy.

Viscount HB ，Eid AJ ，Espy MJ ，Griffin MD ，Thomsen KM ，Harmsen WS ，Razonable RR ，Smith TF ... -  《TRANSPLANTATION》

Systematic screening of BK virus by real-time PCR prevents BK virus associated nephropathy in renal transplant recipients.

BK virus associated nephropathy occurs in approximately 5% of renal transplant recipients. Quantitation of BKV DNA in serum/plasma early in the course of disease has been suggested to be an important diagnostic tool for polymavirus-associated nephropathy (PVAN). The aim of this study was to develop a BKV real-time PCR (qPCR), which could be included in a diagnostic qPCR platform. Additionally, the significance of the assay as a surrogate marker for PVAN was investigated. Quantitation of BKV DNA by qPCR was carried out on 234 serum samples from a retrospective study including 31 renal transplant recipients monitored for at least 6 months post-transplantation. BKV viremia was detected in 9 out of 31 patients. Four patients had a viral load of >10,000 copies/ml at least on one occasion. In two of these patients, PVAN was diagnosed clinically during the study period. In retrospect, these patients were shown to be BKV positive before the clinical diagnosis of PVAN was made. Another two patients had a permanent graft dysfunction, but were never clinically diagnosed with PVAN. None of the remaining five patients with BKV DNA (<10,000 copies/ml) had renal impairment. Based on these results, an algorithm was introduced at the study center in 2006 and to date, August 2011, no cases of PVAN with loss of graft have been observed. The concept of including different PCR protocols in a common qPCR platform allows laboratories with small sample numbers to perform regularly a variety of assays at a reasonable cost.

Hammarin AL ，Öqvist B ，Wahlgren J ，Falk KI ... -  《-》

Prospective monitoring of BK virus replication in renal transplant recipients.

Koukoulaki M ，Grispou E ，Pistolas D ，Balaska K ，Apostolou T ，Anagnostopoulou M ，Tseleni-Kotsovili A ，Hadjiconstantinou V ，Paniara O ，Saroglou G ，Legakis N ，Drakopoulos S ... -  《-》