Emily M Eichenberger, Wairimu Magua, Geeta Karadkhele, Grace Zhou, Payaswini Vasanth, Christian Larsen
{"title":"重度持续性BK多瘤病毒对肾移植受者移植物功能和生活质量的影响","authors":"Emily M Eichenberger, Wairimu Magua, Geeta Karadkhele, Grace Zhou, Payaswini Vasanth, Christian Larsen","doi":"10.1111/tid.70010","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The risk factors and outcomes associated with severe persistent BK polyomavirus (BKPyV) in kidney transplant recipients (KTR) are unknown.</p><p><strong>Methods: </strong>This is a single-center retrospective study of KTR with severe persistent BKPyV compared to (1) KTR with low/no BKPyV-DNAemia and (2) KTR with high BKPyV-DNAemia. Severe persistent BKPyV was defined as BKPyV load reaching > 6 log<sub>10</sub> (1 000 000 copies/mL) for ≥ 90 days. Low/no BKPyV was defined as BKPyV load remaining < 3 log<sub>10</sub> (1000 copies/mL), and high BKPyV was defined as BKPyV load ≥ 3 log<sub>10</sub> without meeting criteria for severe persistent BKPyV.</p><p><strong>Results: </strong>Out of 2586 KTR, 22 had severe persistent BKPyV and were compared to 1843 KTR with low/no BKPyV and 721 KTR with high BKPyV. A low absolute lymphocyte count during the first month posttransplant was associated with an increased risk of severe persistent BKPyV relative to those with low/no BKPyV and high BKPyV (OR 0.91, 95%CI 0.84, 0.99). KTR with severe persistent BKPyV had significantly lower eGFR at 2 years posttransplant relative to low/no and high BKPyV groups eGFR (36 vs. 61 and 59 mL/min; p < 0.001 for both). Additionally, KTR with severe persistent BKPyV required more lab draws and incurred significantly higher total lab-associated costs relative to KTR with low/no BKPyV and high BKPyV ($7516 vs. $4631, p < 0.001; $7516 vs. $5811, p < 0.001, respectively).</p><p><strong>Conclusions: </strong>Severe persistent BKPyV is uncommon but associated with poor outcomes including impaired renal function, a higher burden of labs, and lab-associated costs. Future studies are needed to determine underlying factors that predict severe persistent BKPyV.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70010"},"PeriodicalIF":2.6000,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of Severe Persistent BK Polyomavirus on Graft Function and Quality of Life Outcomes in Kidney Transplant Recipients.\",\"authors\":\"Emily M Eichenberger, Wairimu Magua, Geeta Karadkhele, Grace Zhou, Payaswini Vasanth, Christian Larsen\",\"doi\":\"10.1111/tid.70010\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The risk factors and outcomes associated with severe persistent BK polyomavirus (BKPyV) in kidney transplant recipients (KTR) are unknown.</p><p><strong>Methods: </strong>This is a single-center retrospective study of KTR with severe persistent BKPyV compared to (1) KTR with low/no BKPyV-DNAemia and (2) KTR with high BKPyV-DNAemia. Severe persistent BKPyV was defined as BKPyV load reaching > 6 log<sub>10</sub> (1 000 000 copies/mL) for ≥ 90 days. Low/no BKPyV was defined as BKPyV load remaining < 3 log<sub>10</sub> (1000 copies/mL), and high BKPyV was defined as BKPyV load ≥ 3 log<sub>10</sub> without meeting criteria for severe persistent BKPyV.</p><p><strong>Results: </strong>Out of 2586 KTR, 22 had severe persistent BKPyV and were compared to 1843 KTR with low/no BKPyV and 721 KTR with high BKPyV. A low absolute lymphocyte count during the first month posttransplant was associated with an increased risk of severe persistent BKPyV relative to those with low/no BKPyV and high BKPyV (OR 0.91, 95%CI 0.84, 0.99). KTR with severe persistent BKPyV had significantly lower eGFR at 2 years posttransplant relative to low/no and high BKPyV groups eGFR (36 vs. 61 and 59 mL/min; p < 0.001 for both). Additionally, KTR with severe persistent BKPyV required more lab draws and incurred significantly higher total lab-associated costs relative to KTR with low/no BKPyV and high BKPyV ($7516 vs. $4631, p < 0.001; $7516 vs. $5811, p < 0.001, respectively).</p><p><strong>Conclusions: </strong>Severe persistent BKPyV is uncommon but associated with poor outcomes including impaired renal function, a higher burden of labs, and lab-associated costs. Future studies are needed to determine underlying factors that predict severe persistent BKPyV.</p>\",\"PeriodicalId\":23318,\"journal\":{\"name\":\"Transplant Infectious Disease\",\"volume\":\" \",\"pages\":\"e70010\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-03-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Transplant Infectious Disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/tid.70010\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplant Infectious Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/tid.70010","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Impact of Severe Persistent BK Polyomavirus on Graft Function and Quality of Life Outcomes in Kidney Transplant Recipients.
Background: The risk factors and outcomes associated with severe persistent BK polyomavirus (BKPyV) in kidney transplant recipients (KTR) are unknown.
Methods: This is a single-center retrospective study of KTR with severe persistent BKPyV compared to (1) KTR with low/no BKPyV-DNAemia and (2) KTR with high BKPyV-DNAemia. Severe persistent BKPyV was defined as BKPyV load reaching > 6 log10 (1 000 000 copies/mL) for ≥ 90 days. Low/no BKPyV was defined as BKPyV load remaining < 3 log10 (1000 copies/mL), and high BKPyV was defined as BKPyV load ≥ 3 log10 without meeting criteria for severe persistent BKPyV.
Results: Out of 2586 KTR, 22 had severe persistent BKPyV and were compared to 1843 KTR with low/no BKPyV and 721 KTR with high BKPyV. A low absolute lymphocyte count during the first month posttransplant was associated with an increased risk of severe persistent BKPyV relative to those with low/no BKPyV and high BKPyV (OR 0.91, 95%CI 0.84, 0.99). KTR with severe persistent BKPyV had significantly lower eGFR at 2 years posttransplant relative to low/no and high BKPyV groups eGFR (36 vs. 61 and 59 mL/min; p < 0.001 for both). Additionally, KTR with severe persistent BKPyV required more lab draws and incurred significantly higher total lab-associated costs relative to KTR with low/no BKPyV and high BKPyV ($7516 vs. $4631, p < 0.001; $7516 vs. $5811, p < 0.001, respectively).
Conclusions: Severe persistent BKPyV is uncommon but associated with poor outcomes including impaired renal function, a higher burden of labs, and lab-associated costs. Future studies are needed to determine underlying factors that predict severe persistent BKPyV.
期刊介绍：
Transplant Infectious Disease has been established as a forum for presenting the most current information on the prevention and treatment of infection complicating organ and bone marrow transplantation. The point of view of the journal is that infection and allograft rejection (or graft-versus-host disease) are closely intertwined, and that advances in one area will have immediate consequences on the other. The interaction of the transplant recipient with potential microbial invaders, the impact of immunosuppressive strategies on this interaction, and the effects of cytokines, growth factors, and chemokines liberated during the course of infections, rejection, or graft-versus-host disease are central to the interests and mission of this journal.
Transplant Infectious Disease is aimed at disseminating the latest information relevant to the infectious disease complications of transplantation to clinicians and scientists involved in bone marrow, kidney, liver, heart, lung, intestinal, and pancreatic transplantation. The infectious disease consequences and concerns regarding innovative transplant strategies, from novel immunosuppressive agents to xenotransplantation, are very much a concern of this journal. In addition, this journal feels a particular responsibility to inform primary care practitioners in the community, who increasingly are sharing the responsibility for the care of these patients, of the special considerations regarding the prevention and treatment of infection in transplant recipients. As exemplified by the international editorial board, articles are sought throughout the world that address both general issues and those of a more restricted geographic import.
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