Treatment for BK virus: incidence, risk factors and outcomes for kidney transplant recipients in the United States.
There has been a notable rise of BK virus among kidney transplant recipients. Single-center reports have identified risk factors for development of BK virus. However, there has not been an assessment of risk factors and incidence of this complication at a national level. This study utilized newly collected follow-up information from the national SRTR database to investigate incidence, risk factors and outcomes for solitary kidney transplant recipients associated with treatment for BK virus (TBKV) from 2004 to 2006. Logistic and Cox models were utilized to assess risk factors and evaluate graft survival associated with TBKV. Incidence of TBKV was 1.6% at 6 months and 2.6% at 1 year following transplantation. Patients with and without TBKV at 6 months had 79% and 90% 3-year overall graft survival respectively. Risk factors included advanced donor age, pediatric, African American and male recipients, human leukocyte antigen-mismatching and tacrolimus and thymoglobulin induction as baseline immunosuppression. Acute rejection episodes were more frequent prior to and following TBKV. TBKV is a common and rising incidence, varies based on transplant characteristics and should be included as a safety endpoint in studies investigating immunosuppressive protocols. Careful monitoring and further understanding of disease etiology and treatment strategies are needed.
Schold
Jesse D
JD
Department of Medicine, University of Florida, Gainesville, FL 32610, USA.
Rehman
Shezhad
S
Kayle
Liise K
LK
Kayler
Liise K
LK
Magliocca
Joseph
J
Srinivas
Titte R
TR
Meier-Kriesche
Herwig-Ulf
HU
D000367:Age Factors; D001739:BK Virus; D002648:Child; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D027601:Polyomavirus Infections / Q000188:drug therapy* / Q000453:epidemiology; D012307:Risk Factors; D014019:Tissue Donors; D016896:Treatment Outcome; D014412:Tumor Virus Infections / Q000188:drug therapy* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology