Impact of donor kidney histopathological lesions on BK virus infection and its progression risk after kidney transplantation
10.12464/j.issn.1674-7445.2025031
- VernacularTitle:供肾组织病理学病变对肾移植术后BK病毒感染及其进展风险的影响
- Author:
Huimeng WANG
1
;
Jiajia SUN
1
;
Yongsheng LUO
1
;
Xiaohu LI
1
;
Jinfeng LI
1
Author Information
1. Department of Kidney Transplantation, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
- Publication Type:OriginalArticle
- Keywords:
Kidney transplantation;
Donor kidney zero-hour biopsy;
BK virus infection;
Tubular atrophy;
Glomerulosclerosis;
Renal interstitial fibrosis;
Renal tubular epithelial cell;
Ischemia-reperfusion injury
- From:
Organ Transplantation
2025;16(3):443-452
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the impact of donor kidney histopathological lesions on the risk of BK virus (BKV) infection and progression after kidney transplantation. Methods A retrospective analysis was conducted on the clinical data of 326 kidney transplant recipients from deceased donors at the Department of Kidney Transplantation, the First Affiliated Hospital of Zhengzhou University, from January 2019 to June 2020. The recipients were divided into two groups based on whether BKV infection occurred after kidney transplantation: the BKV infection group (145 cases) and the non-BKV infection group (181 cases). The correlation between donor kidney histopathological findings from zero-hour biopsy and BKV infection, as well as the impact on the risk and progression of BKV infection, was analyzed. Results The incidence of BKV infection among the 326 kidney transplant recipients was 44.5% (145/326). The clearance rate of BKV after infection was 82.1% (119/145), while 17.9% (26/145) progressed to BKV viremia. Among the 326 qualified kidney biopsy specimens, 32 cases showed mild tubular atrophy, 324 cases had mild acute tubular injury, 27 cases exhibited mild hyaline arteriosclerosis, 10 cases had moderate to severe hyaline arteriosclerosis, 7 cases showed mild interstitial inflammation, 23 cases had mild interstitial fibrosis, 6 cases exhibited mild arterial intimal fibrosis, and 1 case had moderate to severe arterial intimal fibrosis. Multivariate logistic regression analysis revealed that male recipients, donor age and tubular atrophy were independent risk factors for BKV infection (all P<0.05). Tubular atrophy was also an independent risk factor for the progression from BKV uria to BKV viremia (P<0.05). Conclusions Donor kidney histopathological lesions have a certain impact on BKV infection and progression after kidney transplantation. Patients with more severe tubular atrophy in donor kidneys have a higher risk of BKV infection after kidney transplantation and are more likely to progress to BKV viremia.
