Journal article
Deceased-Donor Acute Kidney Injury and BK Polyomavirus in Kidney Transplant Recipients
Clinical journal of the American Society of Nephrology, v 16(5), pp 765-775
08 May 2021
PMID: 33692117
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BK polyomavirus (BKV) infection commonly complicates kidney transplantation, contributing to morbidity and allograft failure. The virus is often donor-derived and influenced by ischemia-reperfusion processes and disruption of structural allograft integrity. We hypothesized that deceased-donor AKI associates with BKV infection in recipients.
We studied 1025 kidney recipients from 801 deceased donors transplanted between 2010 and 2013, at 13 academic centers. We fitted Cox proportional-hazards models for BKV DNAemia (detectable in recipient blood by clinical PCR testing) within 1 year post-transplantation, adjusting for donor AKI and other donor- and recipient-related factors. We validated findings from this prospective cohort with analyses for graft failure attributed to BKV within the Organ Procurement and Transplantation Network (OPTN) database.
The multicenter cohort mean kidney donor profile index was 49±27%, and 26% of donors had AKI. Mean recipient age was 54±13 years, and 25% developed BKV DNAemia. Donor AKI was associated with lower risk for BKV DNAemia (adjusted hazard ratio, 0.53; 95% confidence interval, 0.36 to 0.79). In the OPTN database, 22,537 (25%) patients received donor AKI kidneys, and 272 (0.3%) developed graft failure from BKV. The adjusted hazard ratio for the outcome with donor AKI was 0.7 (95% confidence interval, 0.52 to 0.95).
In a well-characterized, multicenter cohort, contrary to our hypothesis, deceased-donor AKI independently associated with lower risk for BKV DNAemia. Within the OPTN database, donor AKI was also associated with lower risk for graft failure attributed to BKV.
This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2021_03_10_CJN18101120_final.mp3.
Metrics
Details
- Title
- Deceased-Donor Acute Kidney Injury and BK Polyomavirus in Kidney Transplant Recipients
- Creators
- Isaac E Hall - University of UtahPeter Philip Reese - University of PennsylvaniaSherry G Mansour - Yale UniversitySumit Mohan - Columbia UniversityYaqi Jia - Johns Hopkins MedicineHeather R Thiessen-Philbrook - Johns Hopkins MedicineDaniel C Brennan - Johns Hopkins MedicineMona D Doshi - University of MichiganThangamani Muthukumar - Presbyterian HospitalEnver Akalin - Albert Einstein College of MedicineMeera Nair Harhay - Drexel UniversityBernd Schröppel - University Hospital UlmPooja Singh - Thomas Jefferson UniversityFrancis L Weng - Saint Barnabas Medical CenterJonathan S Bromberg - University of Maryland, BaltimoreChirag R Parikh - Johns Hopkins Medicine
- Publication Details
- Clinical journal of the American Society of Nephrology, v 16(5), pp 765-775
- Grant note
- UL1 TR002538 / NCATS NIH HHS UL1 TR001863 / NCATS NIH HHS R01 DK093770 / NIDDK NIH HHS KL2 TR002539 / NCATS NIH HHS K24 DK090203 / NIDDK NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000655444500015
- Scopus ID
- 2-s2.0-85107082174
- Other Identifier
- 991019335321504721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Urology & Nephrology