Volume 12 Issue 3
May  2021
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Article Navigation >  ORGAN TRANSPLANTATION  > 2021  >  12(3): 317-323
Xiong Rui, Ding Limin, Yang Hua, et al. Analysis of risk factors of high-level BK viruria after renal transplantation[J]. ORGAN TRANSPLANTATION, 2021, 12(3): 317-323. doi: 10.3969/j.issn.1674-7445.2021.03.010
Citation: Xiong Rui, Ding Limin, Yang Hua, et al. Analysis of risk factors of high-level BK viruria after renal transplantation[J]. ORGAN TRANSPLANTATION, 2021, 12(3): 317-323. doi: 10.3969/j.issn.1674-7445.2021.03.010
shu

Analysis of risk factors of high-level BK viruria after renal transplantation

doi: 10.3969/j.issn.1674-7445.2021.03.010

  • Department of Organ Transplantation, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang 330006, China

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  • Corresponding author: Li Xinchang, Email: lixinchang001@hotmail.com
  • Received Date: 2021-01-23
    Available Online: 2021-05-19
  • Publish Date: 2021-05-15
    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.

     

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