Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK.
Department of Chemical Engineering, Imperial College London, South Kensington Campus, London, SW7 2AZ, UK.
Sci Rep. 2021 Jan 28;11(1):2468. doi: 10.1038/s41598-021-82160-0.
BK virus associated nephropathy (BKN) is an important cause of kidney allograft failure. In a cohort of paediatric kidney transplant recipients, we aimed to understand the incidence and clinical outcome associated with BKN, as well as identify risk factors for BKN and BK viraemia development. We retrospectively analysed all patients who received a kidney transplant and received follow up care in our centre between 2009-2019. Among 106 patients included in the study (mean follow up 4.5 years), 32/106 (30.2%) patients experienced BK viraemia. The incidence of BKN was 7/106 (6.6%). The median time of BK viraemia development post-transplant was 279.5 days compared to 90.0 days for BKN. Development of BKN was associated with younger age at transplantation (p = 0.013). Development of BK viraemia was associated with negative recipient serology for cytomegalovirus (CMV) at time of transplantation (p = 0.012) and a higher net level of immunosuppression (p = 0.039). There was no difference in graft function at latest follow up between those who experienced BKN and those without BKN. This study demonstrates that BK virus infection is associated with younger age at transplantation, CMV negative recipient serostatus and higher levels of immunosuppression. Judicious monitoring of BK viraemia in paediatric transplant recipients, coupled with timely clinical intervention can result in similar long-term outcomes for BKN patients compared to controls.
BK 病毒相关性肾病（BKN）是导致肾移植失败的重要原因。在一组儿科肾移植受者中，我们旨在了解 BKN 相关的发病率和临床结局，以及确定 BKN 和 BK 病毒血症发展的危险因素。我们回顾性分析了 2009 年至 2019 年期间在我们中心接受肾移植并接受随访的所有患者。在纳入研究的 106 例患者中（平均随访 4.5 年），32/106（30.2%）例患者发生 BK 病毒血症。BKN 的发病率为 7/106（6.6%）。移植后发生 BK 病毒血症的中位时间为 279.5 天，而 BKN 为 90.0 天。BKN 的发展与移植时年龄较小（p=0.013）相关。BK 病毒血症的发生与移植时受者巨细胞病毒（CMV）血清学阴性（p=0.012）和更高的免疫抑制净水平（p=0.039）相关。在最新随访时，发生 BKN 与未发生 BKN 的患者的移植物功能无差异。本研究表明，BK 病毒感染与移植时年龄较小、CMV 受者血清阴性和更高水平的免疫抑制相关。在儿科移植受者中，对 BK 病毒血症进行谨慎监测，并及时进行临床干预，可以使 BKN 患者与对照组获得相似的长期结局。
