title: Pretransplant serologic testing to identify the risk of polyoma BK viremia in pediatric kidney transplant recipients.
abstract: This study investigated the age-related prevalence of a prior polyoma BKV infection at the time of transplantation and association with subsequent development of BKV viremia. We measured BKV-specific antibody titers in stored serum samples obtained before transplantation in 94 pediatric kidney transplant recipients (in a single-center, retrospective analysis) and 40 matched donors from 1986 to 2007. Titers were categorized as LOW or HIGH serostatus at titers of ≤ 1:2560 and ≥ 1:10 240, respectively. Of these, 36 recipients transplanted since 2002 were prospectively screened for BKV viremia. Seventeen percent of recipients aged 0-6 yr had HIGH BKV serostatus compared with 73% of older recipients (p < 0.002). The prevalence of HIGH donor BKV serostatus was 73%. Five prospectively screened patients (14%) developed early BKV viremia, and an additional 4 (11%) had late onset of BKV viremia. There were three cases (8%) of BKVAN. LOW BKV serostatus was significantly associated with early BKV viremia (p = 0.02). Donor HIGH to recipient LOW (HIGH/LOW) had the highest risk of BKV viremia (4/7; 57%), compared with LOW/LOW (0/3; 0%) and recipient HIGH (1/26; 4%) (p = 0.004). BKV IgG titers are low in young pediatric kidney transplant recipients, and LOW BKV serostatus is associated with an increased risk of early BKV infection post-transplant, particularly in the context of donor with HIGH BKV serostatus.
authors: Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.
authors: Abdalla M
authors: AM
authors: Ali
authors: Ian W
authors: IW
authors: Gibson
authors: Patricia
authors: P
authors: Birk
authors: Tom D
authors: TD
authors: Blydt-Hansen
mesh_terms: D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D011120:Polyomavirus / Q000302:isolation & purification*; D027601:Polyomavirus Infections / Q000175:diagnosis*; D011300:Preoperative Care; D012307:Risk Factors; D012698:Serologic Tests; D014412:Tumor Virus Infections / Q000175:diagnosis*; D014766:Viremia / Q000175:diagnosis*
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G