Doucette Karen E, Pang Xiaoli L, Jackson Kathleen, Burton Ilene, Carbonneau Michelle, Cockfield Sandra, Preiksaitis Jutta K
Division of Infectious Diseases, University of Alberta, Edmonton, Canada.
Transplantation. 2008 Jun 27;85(12):1733-6. doi: 10.1097/TP.0b013e3181722ead.
BK virus-associated nephropathy is an important cause of renal dysfunction in renal transplant recipients. Renal dysfunction after nonrenal solid organ transplantation (NRSOT) is common; however, the impact of BK virus remains uncertain.
Sixty (7 heart, 25 liver, and 28 lung) NRSOT recipients were enrolled in this single center prospective longitudinal study. Urine and plasma were collected for detection of BK viral load using a real-time quantitative polymerase chain reaction assay at transplantation and at 3, 6, and 9 months posttransplantation. Demographic and clinical data including serum creatinine and immunosuppressive therapy were also collected.
BK viruria was detected in 16 of 193 (8.3%) samples corresponding to 9 of 60 (15%) subjects. The median BK viral load was 1.12 x 10 (range, 1.1 x 10-2.66 x 10) copies per milliliter. No viremia was detected. In seven of nine, viruria occurred by 3 months posttransplantation. At 9 months of posttransplantation, the median Modification of Diet in Renal Disease-estimated glomerular filtration rate in those with BK viruria on at least one sample was similar to those without viruria (58.0 [IQR 43.1-60.7] mL/min/1.73 m vs. 61.4 [IQR 50.6-74.4] mL/min/1.73 m; P=0.39).
Although BK infection was common in this NRSOT population, BK viremia was not observed and there was no association between BK viruria and renal dysfunction. Our data suggest that routine surveillance for BK virus early posttransplantation in NRSOT may not be warranted but should be further examined in a larger multicenter trial.
BK病毒相关性肾病是肾移植受者肾功能不全的重要原因。非肾实体器官移植（NRSOT）后肾功能不全很常见；然而，BK病毒的影响仍不确定。
60例（7例心脏、25例肝脏和28例肺）NRSOT受者纳入了这项单中心前瞻性纵向研究。在移植时以及移植后3、6和9个月收集尿液和血浆，使用实时定量聚合酶链反应测定法检测BK病毒载量。还收集了包括血清肌酐和免疫抑制治疗在内的人口统计学和临床数据。
在193份样本中的16份（8.3%）检测到BK病毒尿，对应60名受试者中的9名（15%）。BK病毒载量中位数为每毫升1.12×10（范围为1.1×10至2.66×10）拷贝。未检测到病毒血症。9例中的7例在移植后3个月内出现病毒尿。移植后9个月，至少有一份样本检测到BK病毒尿者的肾脏病饮食改良法估计肾小球滤过率中位数与未出现病毒尿者相似（58.0[四分位间距43.1 - 60.7]mL/min/1.73m²对61.4[四分位间距50.6 - 74.4]mL/min/1.73m²；P = 0.39）。
虽然BK感染在该NRSOT人群中很常见，但未观察到BK病毒血症，且BK病毒尿与肾功能不全之间无关联。我们的数据表明，NRSOT术后早期对BK病毒进行常规监测可能没有必要，但应在更大规模的多中心试验中进一步研究。
