Analysis of risk factors of high-level BK viruria after renal transplantation
10.3969/j.issn.1674-7445.2021.03.010
- VernacularTitle:肾移植术后高水平BK病毒尿症危险因素分析
- Author:
Rui XIONG
1
;
Limin DING
;
Hua YANG
;
Xinchang LI
Author Information
1. Department of Organ Transplantation, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang 330006, China
- Publication Type:Research Article
- Keywords:
Renal transplantation;
BK virus;
BK viruria;
BK viremia;
BK virus-associated nephropathy (BKVAN);
Acute rejection (AR);
Delayed graft function (DGF);
Donation after brain death followed by cardiac death (DBCD)
- From:
Organ Transplantation
2021;12(3):317-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the risk factors of high-level BK viruria after renal transplantation and the significance in preventing BK virus-associated nephropathy (BKVAN). Methods Clinical data of 262 renal transplant recipients with regular follow-up data were retrospectively analyzed. According to the DNA load of BK virus, all recipients were divided into the high-level BK viruria group (n=35) and non-high-level BK viruria group (n=227). The incidence of high-level BK viruria after renal transplantation was summarized. The risk factors of high-level BK viruria after renal transplantation were analyzed by univariate analysis and multivariate analysis. Survival curve was delineated by Kaplan-Meier method, and survival analysis of recipients was performed. Results Among 262 renal transplant recipients, 35 cases developed high-level BK viruria with an incidence of 13.4%. The median time of occurrence of high-level BK viruria was 181 (126, 315) d. The incidence was the highest within 6 months after renal transplantation, gradually decreased from 6 months to 2 years, and then increased after 2 years. Univariate analysis showed that the history of antithymocyte globulin (ATG) treatment, acute rejection (AR), donation type and delayed graft function (DGF) were the risk factors of high-level BK viruria after renal transplantation (all P < 0.05). Multivariate Cox regression analysis demonstrated that donation after brain death followed by cardiac death (DBCD), AR and DGF were the independent risk factors of high-level BK viruria after renal transplantation. The 1-, 3- and 5-year survival rates of recipients with ATG treatment history, AR, DGF and donation type of DBCD were significantly lower than those with non-ATG treatment history, non-AR, non-DGF and other donation types [donation after brain death (DBD), donation after cardiac death (DCD) and living organ donation] respectively (all P < 0.05). Conclusions DBCD, AR and DGF are the independent risk factors of high-level BK viruria after renal transplantation. Strengthening the postoperative monitoring of these recipients and delivering early intervention may effectively prevent BKVAN.
