From the Urology Department Son Espases Universitary Hospital, Palma de Mallorca, Islas Baleares, Spain.
Exp Clin Transplant. 2020 Aug;18(4):458-462. doi: 10.6002/ect.2019.0425. Epub 2020 Jun 2.
BK polyomavirus is one of the main causes of chronic renal failure and ureteral stenosis in kidney transplant recipients, affecting approximately 15% of kidney transplant patients during the first year after transplant. The immunosuppressive treatment used in these recipients allows a reactivation of the virus by allowing infection, which can manifest from viruria, viremia, or nephropathy. The use of ureteral stents in renal transplant to prevent postoperative complications has been associated with an increase in BK polyomavirus nephropathy. Our objective was to describe associations between viruria and viremia and our reimplantation surgical technique and ureteral stenting.
We conducted a retrospective review of 184 transplant recipients who were seen at our center between January 2013 and December 2016. To define possible risk factors from analysis of different variables, we categorized patients into 3 groups: patients who did not present with either viremia or viruria caused by BK virus, patients who presented with viremia, and patients who presented with viruria.
We found that 127 transplant recipients (69%) presented with neither BK viruria nor BK viremia, 11 recipients (6%) presented with BK viremia, and 46 recipients (25%) presented with BK viruria. No patient in the study had BK polyomavirus nephropathy.
Our type of ureteral stenting has a low rate of BK viruria and BK viremia compared with other studies. In addition, with our technique, the ureteral stent removal procedure does not require an invasive endoscopic procedure, thereby avoiding the consequent economic and assistance inconvenience typically associated with an endoscopic procedure.
BK 多瘤病毒是导致肾移植受者慢性肾衰竭和输尿管狭窄的主要原因之一，约占移植后 1 年内 15%的肾移植患者。这些受者使用的免疫抑制治疗允许病毒感染，从而导致病毒再激活，可表现为尿病毒血症、病毒血症或肾病。在肾移植中使用输尿管支架以预防术后并发症与 BK 多瘤病毒肾病的发生率增加有关。我们的目的是描述尿病毒血症和病毒血症与我们的再植入手术技术和输尿管支架之间的关系。
我们对 2013 年 1 月至 2016 年 12 月在我们中心就诊的 184 名移植受者进行了回顾性研究。为了通过分析不同变量来定义可能的危险因素，我们将患者分为 3 组：未出现 BK 病毒引起的病毒血症或尿病毒血症的患者、出现病毒血症的患者和出现尿病毒血症的患者。
我们发现，127 名（69%）移植受者既没有 BK 尿病毒血症，也没有 BK 病毒血症，11 名（6%）受者出现 BK 病毒血症，46 名（25%）受者出现 BK 尿病毒血症。在研究中没有患者出现 BK 多瘤病毒肾病。
与其他研究相比，我们的输尿管支架类型的 BK 尿病毒血症和 BK 病毒血症发生率较低。此外，使用我们的技术，输尿管支架取出过程不需要侵入性内窥镜程序，从而避免了通常与内窥镜程序相关的经济和辅助不便。
