医学
免疫抑制
肾病
BK病毒
肾移植
病毒载量
移植
肺移植
肾
肾脏疾病
内科学
肺
泌尿科
胃肠病学
免疫学
病毒
内分泌学
糖尿病
作者
Geoffrey K. Dube,Ibrahim Batal,Lori Shah,Hilary A. Robbins,Selim M. Arcasoy,S. Ali Husain
标识
DOI:10.1016/j.ajt.2022.11.007
摘要
BK virus DNAemia (BKPyV) and nephropathy are common after kidney transplant; however, there are limited data on BK infections in nonrenal solid organ transplant recipients. We examined the frequency, clinical and pathologic features, and kidney and lung outcomes of BKPyV and BK virus native kidney nephropathy (BKVN) in lung transplant recipients at our center. Among 878 recipients transplanted from 2003 to 2019, 56 (6%) developed BKPyV at a median of 30.1 months after transplant (range, 0.6-213) and 11 (1.3%) developed BKVN at a median of 46 months after transplant (range, 9-213). The incidence of end-stage kidney disease was significantly higher in patients with peak viral load ≥10 000 copies/mL (39% vs 8%, P < .001). All cases of BKVN were in patients with peak viral load of ≥10 000 copies/mL, and 55% of these patients developed end-stage kidney disease. Despite the reduction of immunosuppression to treat BKVN, only 1 patient developed acute rejection, and lung function was stable >1 year. BKPyV and nephropathy are more common after lung transplantation than previously reported. Routine screening for BKPyV should be considered in all lung transplant recipients.
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