Urine cytology screening for polyoma virus infection following renal transplantation: the Oxford experience.
OBJECTIVE
To review the first year of a monthly urine cytology screening service, introduced to identify renal transplant patients at risk of polyoma virus nephropathy (PVN), at an early, potentially treatable, stage.


RESULTS
Monthly urine samples (n = 392) were received from 97/108 transplant recipients in 2005. Of 56 patients with follow-up >6 months, 20% and 9% had significant (>10 decoy cells/cytospin) and non-significant positive cytology, respectively. The first positive urine samples occurred most commonly in the second and third month post-transplantation and patients with significantly positive samples had higher 3-month and 6-month serum creatinine levels than patients with negative urine cytology (p<0.01). Four patients with positive urine cytology had a subsequent positive plasma BK virus PCR; 3/97 patients had biopsy-proven PVN, all in the third month, 1-6 weeks after first positive urine samples.


CONCLUSIONS
Significant PV viruria is common following renal transplantation with onset usually within the first 3 months. Viruria is associated with worse graft function at 3 and 6 months. The time between urine positivity and clinical PVN is short. More frequent early urine screening would be required to achieve clinical benefit.
Thamboo
Thomas P
TP
Department of Pathology, National University of Singapore, National University Hospital, Singapore.
Jeffery
Katie J M
KJ
Friend
Peter J
PJ
Turner
Gareth D H
GD
Roberts
Ian S D
IS
D000890:Anti-Infective Agents / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007674:Kidney Diseases / Q000175:diagnosis / Q000652:urine*; D016030:Kidney Transplantation; D016133:Polymerase Chain Reaction / Q000379:methods; D011120:Polyomavirus / Q000302:isolation & purification; D027601:Polyomavirus Infections / Q000175:diagnosis / Q000188:drug therapy / Q000652:urine*; D011183:Postoperative Complications; D014412:Tumor Virus Infections / Q000175:diagnosis / Q000188:drug therapy / Q000652:urine*
D000890:Anti-Infective Agents; D002939:Ciprofloxacin