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Epidemiology of and Risk Factors for BK Polyomavirus Replication and Nephropathy in Pediatric Renal Transplant Recipients: An International CERTAIN Registry Study

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Epidemiology of and Risk Factors for BK Polyomavirus Replication and Nephropathy in Pediatric Renal Transplant Recipients: An International CERTAIN Registry Study. / Höcker, Britta; Schneble, Lukas; Murer, Luisa; Carraro, Andrea; Pape, Lars; Kranz, Birgitta; Oh, Jun; Zirngibl, Matthias; Dello Strologo, Luca; Büscher, Anja; Weber, Lutz T; Awan, Atif; Pohl, Martin; Bald, Martin; Printza, Nikoleta; Rusai, Krisztina; Peruzzi, Licia; Topaloglu, Rezan; Fichtner, Alexander; Krupka, Kai; Köster, Lennart; Bruckner, Thomas; Schnitzler, Paul; Hirsch, Hans H; Tönshoff, Burkhard.

in: TRANSPLANTATION, Jahrgang 103, Nr. 6, 06.2019, S. 1224-1233.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Höcker, B, Schneble, L, Murer, L, Carraro, A, Pape, L, Kranz, B, Oh, J, Zirngibl, M, Dello Strologo, L, Büscher, A, Weber, LT, Awan, A, Pohl, M, Bald, M, Printza, N, Rusai, K, Peruzzi, L, Topaloglu, R, Fichtner, A, Krupka, K, Köster, L, Bruckner, T, Schnitzler, P, Hirsch, HH & Tönshoff, B 2019, 'Epidemiology of and Risk Factors for BK Polyomavirus Replication and Nephropathy in Pediatric Renal Transplant Recipients: An International CERTAIN Registry Study', TRANSPLANTATION, Jg. 103, Nr. 6, S. 1224-1233. https://doi.org/10.1097/TP.0000000000002414

APA

Höcker, B., Schneble, L., Murer, L., Carraro, A., Pape, L., Kranz, B., Oh, J., Zirngibl, M., Dello Strologo, L., Büscher, A., Weber, L. T., Awan, A., Pohl, M., Bald, M., Printza, N., Rusai, K., Peruzzi, L., Topaloglu, R., Fichtner, A., ... Tönshoff, B. (2019). Epidemiology of and Risk Factors for BK Polyomavirus Replication and Nephropathy in Pediatric Renal Transplant Recipients: An International CERTAIN Registry Study. TRANSPLANTATION, 103(6), 1224-1233. https://doi.org/10.1097/TP.0000000000002414

Vancouver

Höcker B, Schneble L, Murer L, Carraro A, Pape L, Kranz B et al. Epidemiology of and Risk Factors for BK Polyomavirus Replication and Nephropathy in Pediatric Renal Transplant Recipients: An International CERTAIN Registry Study. TRANSPLANTATION. 2019 Jun;103(6):1224-1233. https://doi.org/10.1097/TP.0000000000002414

Bibtex

@article{8c83e2e8262940579e48956affdecb66,
title = "Epidemiology of and Risk Factors for BK Polyomavirus Replication and Nephropathy in Pediatric Renal Transplant Recipients: An International CERTAIN Registry Study",
abstract = "BACKGROUND: BK polyomavirus-associated nephropathy (BKPyVAN) constitutes a serious cause of kidney allograft failure, but large-scale data in pediatric renal transplant recipients and a comprehensive analysis of specific risk factors are lacking.METHODS: We analyzed the data of 313 patients in the Cooperative European Pediatric Renal Transplant Initiative Registry, with an observation period of 3.3 years (range, 1-5). The net state of immunosuppressive therapy was assessed by the modified Vasudev score.RESULTS: Presumptive BKPyVAN (defined as sustained [>3 wk] high-level BK viremia >10 copies/mL) within 5 years posttransplant occurred in 49 (15.8%) of 311 patients, and biopsy-proven BKPyVAN in 14 (4.5%) of 313. BKPyV viremia was observed in 115 (36.7%) of 311 patients, of whom 11 (9.6%) of 115 developed viremia late, that is, after the second year posttransplant. In 6 (12.5%) of 48 patients with high-level viremia and in 3 (21.4%) of 14 with BKPyVAN, this respective event occurred late. According to multivariable analysis, BKPyV viremia and/or BKPyVAN were associated not only with a higher net state of immunosuppression (odds ratio [OR], 1.3; P < 0.01) and with tacrolimus-based versus ciclosporin-based immunosuppression (OR, 3.6; P < 0.01) but also with younger recipient age (OR, 1.1 per y younger; P < 0.001) and obstructive uropathy (OR, 12.4; P < 0.01) as primary renal disease.CONCLUSIONS: Uncontrolled BKPyV replication affects a significant proportion of pediatric renal transplant recipients and is associated with unique features of epidemiology and risk factors, such as young recipient age, obstructive uropathy, and overall intensity of immunosuppressive therapy. BKPyV surveillance should be considered beyond 2 years posttransplant in pediatric patients at higher risk.",
keywords = "Journal Article",
author = "Britta H{\"o}cker and Lukas Schneble and Luisa Murer and Andrea Carraro and Lars Pape and Birgitta Kranz and Jun Oh and Matthias Zirngibl and {Dello Strologo}, Luca and Anja B{\"u}scher and Weber, {Lutz T} and Atif Awan and Martin Pohl and Martin Bald and Nikoleta Printza and Krisztina Rusai and Licia Peruzzi and Rezan Topaloglu and Alexander Fichtner and Kai Krupka and Lennart K{\"o}ster and Thomas Bruckner and Paul Schnitzler and Hirsch, {Hans H} and Burkhard T{\"o}nshoff",
year = "2019",
month = jun,
doi = "10.1097/TP.0000000000002414",
language = "English",
volume = "103",
pages = "1224--1233",
journal = "TRANSPLANTATION",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

RIS

TY - JOUR

T1 - Epidemiology of and Risk Factors for BK Polyomavirus Replication and Nephropathy in Pediatric Renal Transplant Recipients: An International CERTAIN Registry Study

AU - Höcker, Britta

AU - Schneble, Lukas

AU - Murer, Luisa

AU - Carraro, Andrea

AU - Pape, Lars

AU - Kranz, Birgitta

AU - Oh, Jun

AU - Zirngibl, Matthias

AU - Dello Strologo, Luca

AU - Büscher, Anja

AU - Weber, Lutz T

AU - Awan, Atif

AU - Pohl, Martin

AU - Bald, Martin

AU - Printza, Nikoleta

AU - Rusai, Krisztina

AU - Peruzzi, Licia

AU - Topaloglu, Rezan

AU - Fichtner, Alexander

AU - Krupka, Kai

AU - Köster, Lennart

AU - Bruckner, Thomas

AU - Schnitzler, Paul

AU - Hirsch, Hans H

AU - Tönshoff, Burkhard

PY - 2019/6

Y1 - 2019/6

N2 - BACKGROUND: BK polyomavirus-associated nephropathy (BKPyVAN) constitutes a serious cause of kidney allograft failure, but large-scale data in pediatric renal transplant recipients and a comprehensive analysis of specific risk factors are lacking.METHODS: We analyzed the data of 313 patients in the Cooperative European Pediatric Renal Transplant Initiative Registry, with an observation period of 3.3 years (range, 1-5). The net state of immunosuppressive therapy was assessed by the modified Vasudev score.RESULTS: Presumptive BKPyVAN (defined as sustained [>3 wk] high-level BK viremia >10 copies/mL) within 5 years posttransplant occurred in 49 (15.8%) of 311 patients, and biopsy-proven BKPyVAN in 14 (4.5%) of 313. BKPyV viremia was observed in 115 (36.7%) of 311 patients, of whom 11 (9.6%) of 115 developed viremia late, that is, after the second year posttransplant. In 6 (12.5%) of 48 patients with high-level viremia and in 3 (21.4%) of 14 with BKPyVAN, this respective event occurred late. According to multivariable analysis, BKPyV viremia and/or BKPyVAN were associated not only with a higher net state of immunosuppression (odds ratio [OR], 1.3; P < 0.01) and with tacrolimus-based versus ciclosporin-based immunosuppression (OR, 3.6; P < 0.01) but also with younger recipient age (OR, 1.1 per y younger; P < 0.001) and obstructive uropathy (OR, 12.4; P < 0.01) as primary renal disease.CONCLUSIONS: Uncontrolled BKPyV replication affects a significant proportion of pediatric renal transplant recipients and is associated with unique features of epidemiology and risk factors, such as young recipient age, obstructive uropathy, and overall intensity of immunosuppressive therapy. BKPyV surveillance should be considered beyond 2 years posttransplant in pediatric patients at higher risk.

AB - BACKGROUND: BK polyomavirus-associated nephropathy (BKPyVAN) constitutes a serious cause of kidney allograft failure, but large-scale data in pediatric renal transplant recipients and a comprehensive analysis of specific risk factors are lacking.METHODS: We analyzed the data of 313 patients in the Cooperative European Pediatric Renal Transplant Initiative Registry, with an observation period of 3.3 years (range, 1-5). The net state of immunosuppressive therapy was assessed by the modified Vasudev score.RESULTS: Presumptive BKPyVAN (defined as sustained [>3 wk] high-level BK viremia >10 copies/mL) within 5 years posttransplant occurred in 49 (15.8%) of 311 patients, and biopsy-proven BKPyVAN in 14 (4.5%) of 313. BKPyV viremia was observed in 115 (36.7%) of 311 patients, of whom 11 (9.6%) of 115 developed viremia late, that is, after the second year posttransplant. In 6 (12.5%) of 48 patients with high-level viremia and in 3 (21.4%) of 14 with BKPyVAN, this respective event occurred late. According to multivariable analysis, BKPyV viremia and/or BKPyVAN were associated not only with a higher net state of immunosuppression (odds ratio [OR], 1.3; P < 0.01) and with tacrolimus-based versus ciclosporin-based immunosuppression (OR, 3.6; P < 0.01) but also with younger recipient age (OR, 1.1 per y younger; P < 0.001) and obstructive uropathy (OR, 12.4; P < 0.01) as primary renal disease.CONCLUSIONS: Uncontrolled BKPyV replication affects a significant proportion of pediatric renal transplant recipients and is associated with unique features of epidemiology and risk factors, such as young recipient age, obstructive uropathy, and overall intensity of immunosuppressive therapy. BKPyV surveillance should be considered beyond 2 years posttransplant in pediatric patients at higher risk.

KW - Journal Article

U2 - 10.1097/TP.0000000000002414

DO - 10.1097/TP.0000000000002414

M3 - SCORING: Journal article

C2 - 30130322

VL - 103

SP - 1224

EP - 1233

JO - TRANSPLANTATION

JF - TRANSPLANTATION

SN - 0041-1337

IS - 6

ER -