A prospective cross-sectional study of BK virus infection in non-renal solid organ transplant recipients with chronic renal dysfunction.
BACKGROUND
Polyomavirus (primarily BK virus [BKV]) infection is an important cause of chronic renal dysfunction in renal transplant recipients, but its possible contribution to chronic renal dysfunction in non-renal solid organ transplant (NRSOT) recipients has not been fully explored.


METHODS
We performed a prospective, cross-sectional study of consecutive NRSOT recipients with unexplained chronic renal dysfunction of at least a 3 months duration. Medical records were reviewed, and polymerase chain reaction was used to amplify BKV-specific sequences from serum and urine samples. The potential associations between various demographic and transplant variables and BKV infection were assessed.


RESULTS
Thirty-four consecutive NRSOT recipients (23 lung, 8 liver, 2 heart, 1 heart-lung) with chronic renal dysfunction were enrolled at a median of 3.5 years (range 0.3-12.5 years) post transplantation. Five of the 34 (15%) patients had BKV viruria (range 1040-1.8 x 10(6) copies/mL), but none had BKV viremia. BK viruria was associated with mycophenolate mofetil use (5 of 19 [26%] vs. 0 of 15, P = 0.03) and a history of cytomegalovirus disease (3 of 4 [75%] vs. 2 of 30 [7%], P < 0.01). However, the mean estimated creatinine clearance was similar in patients with or without BKV viruria (49 vs. 47 mL/min).


CONCLUSIONS
BKV viruria was present in a proportion of NRSOT patients with otherwise unexplained chronic renal dysfunction. The possibility that BKV infection might contribute to chronic renal dysfunction in this setting warrants further investigation.
Barton
T D
TD
Department of Medicine, Division of Infectious Diseases, University of Pennsylvania, Philadelphia, 19104, USA. todd.barton@uphs.upenn.edu
Blumberg
E A
EA
Doyle
A
A
Ahya
V N
VN
Ferrenberg
J M
JM
Brozena
S C
SC
Limaye
A P
AP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001739:BK Virus / Q000254:growth & development* / Q000302:isolation & purification / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000097:blood / Q000209:etiology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D027601:Polyomavirus Infections / Q000097:blood / Q000209:etiology / Q000821:virology*; D011446:Prospective Studies; D019737:Transplants
D007166:Immunosuppressive Agents