Department of Pediatrics B, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
Transplantation. 2011 Oct 27;92(8):943-6. doi: 10.1097/TP.0b013e31822e0b9a.
Chronic renal failure (CRF) is a well-documented complication of liver transplantation. BK virus (BKV) is a common cause of CRF in renal-transplant recipients and has been sporadically associated with renal failure after nonrenal solid-organ transplantation. The aims of the study were to determine the prevalence of BK viruria and viremia in pediatric liver-transplant recipients, assess the natural course of BKV infection over time, and examine the association between BKV positivity and renal function.
A prospective, cross-sectional study of 59 pediatric liver-transplant recipients. Blood and urine samples were collected at enrollment for creatinine level and BKV polymerase chain reaction test. BKV-positive patients underwent repeated testing and follow-up. The medical files were reviewed for clinical data.
Median age at enrollment was 11.5 years, and median time from transplantation was 61 months. One child (1.7%) had viremia, and nine children (15.3%) had viruria (median: 610 copies/mL). All cases of viruria/viremia resolved spontaneously, nine of them within 10 months. There were no significant differences in demographic or clinical variables between the BKV-positive and BKV-negative children. None of the BKV-positive patients had evidence of renal dysfunction.
Pediatric liver-transplant recipients have a low prevalence of BK viruria/viremia. BKV infection is associated with low viral loads and resolves spontaneously within a relatively short period, without residua. BKV is not associated with CRF postliver transplantation. BKV testing should not be part of the routine follow-up of children after liver transplantation.
慢性肾衰竭（CRF）是肝移植后一种有据可查的并发症。BK 病毒（BKV）是肾移植受者发生 CRF 的常见原因，并且在非肾实体器官移植后也偶有与肾衰竭相关的报道。本研究旨在确定儿童肝移植受者的 BKV 尿病毒血症和血病毒血症的流行率，评估 BKV 感染随时间的自然病程，并研究 BKV 阳性与肾功能之间的关系。
对 59 例儿童肝移植受者进行前瞻性、横断面研究。在入组时采集血样和尿样进行肌酐水平和 BKV 聚合酶链反应检测。对 BKV 阳性患者进行重复检测和随访。查阅病历以获取临床数据。
入组时的中位年龄为 11.5 岁，移植后中位时间为 61 个月。1 例患儿（1.7%）发生血病毒血症，9 例患儿（15.3%）发生尿病毒血症（中位数：610 拷贝/ml）。所有的病毒血症/病毒尿症均自发消退，其中 9 例在 10 个月内消退。BKV 阳性和 BKV 阴性患儿的人口统计学和临床变量无显著差异。BKV 阳性患儿均无肾功能不全证据。
儿童肝移植受者的 BKV 尿病毒血症/病毒血症发生率较低。BKV 感染与低病毒载量相关，且在相对较短的时间内自发消退，无后遗症。BKV 与肝移植后 CRF 无关。BKV 检测不应作为儿童肝移植后常规随访的一部分。
