Detection of viral DNA in kidney graft preservation and washing solutions is predictive of posttransplant infections in pediatric recipients.
BACKGROUND
In pediatric kidney transplant recipients, viral infections occur soon after transplant and may be transmitted from the graft.


METHODS
This study of 75 pediatric kidney transplants investigated whether genome sequences of parvovirus B19, Epstein-Barr virus (EBV), human cytomegalovirus (HCMV), and BK polyomavirus (BKV) could be detected in kidney graft samples (graft biopsy samples and preservation and washing solutions) collected before implantation and whether their presence was a risk factor for infections in the recipient.


RESULTS
B19 DNA was detected in approximately 30% of graft biopsy samples, preservation solutions, and washing solutions; EBV DNA was detected in approximately 20% of preservation and washing solutions but rarely in biopsy samples; and HCMV DNA and BKV DNA were rarely detected in graft biopsy samples. Seronegative recipients of B19 DNA-positive and EBV DNA-positive grafts had a significantly higher risk of infection during the early posttransplant period than did recipients of negative grafts. In particular, none of the B19-seronegative recipients of B19 DNA-negative grafts experienced infection soon after transplant, whereas most recipients of B19 DNA-positive grafts experienced infection within the first month after transplant.


CONCLUSIONS
Molecular testing of donor grafts for viruses that infect circulating and resident cells in the graft-such as B19 in the kidney-could be useful (in association with donor/recipient serostatus) for identifying recipients at high risk for posttransplant infections.
Department of Histology, Microbiology, and Medical Biotechnologies, University of Padova, Padova, Italy.
Luisa
L
Barzon
Luisa
L
Murer
Monia
M
Pacenti
Maria Angela
MA
Biasolo
Manuela Della
MD
Vella
Giulia
G
Ghirardo
Pier Giorgio
PG
Gamba
Alejandro Espadas
AE
De Arias
Giovanni Franco
GF
Zanon
Giorgio
G
Palù
D000293:Adolescent; D000328:Adult; D001739:BK Virus / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D003587:Cytomegalovirus / Q000302:isolation & purification; D004266:DNA Virus Infections / Q000175:diagnosis* / Q000517:prevention & control; D004279:DNA, Viral / Q000032:analysis / Q000302:isolation & purification*; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D019188:Organ Preservation Solutions / Q000032:analysis*; D016732:Parvovirus B19, Human / Q000302:isolation & purification; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012698:Serologic Tests; D055815:Young Adult
D004279:DNA, Viral; D019188:Organ Preservation Solutions