JC polyomavirus replication and associated disease in pediatric renal Transplantation: an international CERTAIN Registry study
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JC polyomavirus replication and associated disease in pediatric renal Transplantation: an international CERTAIN Registry study. / Höcker, Britta; Tabatabai, Julia; Schneble, Lukas; Oh, Jun; Thiel, Florian; Pape, Lars; Rusai, Krisztina; Topaloglu, Rezan; Kranz, Birgitta; Klaus, Günter; Printza, Nikoleta; Yavascan, Onder; Fichtner, Alexander; Krupka, Kai; Bruckner, Thomas; Waldherr, Rüdiger; Pawlita, Michael; Schnitzler, Paul; Hirsch, Hans H; Tönshoff, Burkhard.
In: PEDIATR NEPHROL, Vol. 33, No. 12, 12.2018, p. 2343-2352.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - JC polyomavirus replication and associated disease in pediatric renal Transplantation: an international CERTAIN Registry study
AU - Höcker, Britta
AU - Tabatabai, Julia
AU - Schneble, Lukas
AU - Oh, Jun
AU - Thiel, Florian
AU - Pape, Lars
AU - Rusai, Krisztina
AU - Topaloglu, Rezan
AU - Kranz, Birgitta
AU - Klaus, Günter
AU - Printza, Nikoleta
AU - Yavascan, Onder
AU - Fichtner, Alexander
AU - Krupka, Kai
AU - Bruckner, Thomas
AU - Waldherr, Rüdiger
AU - Pawlita, Michael
AU - Schnitzler, Paul
AU - Hirsch, Hans H
AU - Tönshoff, Burkhard
PY - 2018/12
Y1 - 2018/12
N2 - BACKGROUND: JC polyomavirus (JCPyV)-associated nephropathy (JCPyVAN) is a severe, but rare complication in adult renal transplant (RTx) recipients. Related data in pediatric patients are scarce.METHODS: Based on the CERTAIN Registry, we therefore performed a multi-center, retrospective study on the JCPyV antibody status, prevalence of JCPyV replication, and its associated disease in 139 pediatric RTx recipients (mean age, 8.5 ± 5.3 years). JCPyV DNA in plasma and/or urine was measured by quantitative PCR at a median time of 3.2 (IQR, 0.3-8.1) years post-transplant.RESULTS: 53.2% of patients were JCPyV-seronegative prior to transplantation; younger age was associated with JCPyV seronegativity. 34/139 (24.5%) patients post-transplant showed active JCPyV replication in either urine (22.0%), plasma (13.4%), or both (7.6%). JCPyV viremia occurred significantly (p < 0.001) more often in patients with viruria (34.6%) than in those without (7.6%), but 7/118 (5.9%) had isolated viremia. High-level viruria (> 107 copies/mL) was found in 29.6% of viruric patients. A higher net state of immunosuppression constituted an independent risk factor for JCPyV replication both in urine and plasma (OR 1.2, p < 0.02). Male patients tended to have a higher risk of JCPyV viremia than females (OR 4.3, p = 0.057). There was one male patient (0.7%) with JCPyVAN 7 years post-transplant, which resolved after reduction of immunosuppressive therapy. No patient exhibited progressive multifocal leukoencephalopathy.CONCLUSIONS: This first multi-center study on JCPyV in pediatric renal transplant recipients shows that JCPyV replication is common (24.5%), with strong immunosuppression being a significant risk factor, but associated nephropathy is rare.
AB - BACKGROUND: JC polyomavirus (JCPyV)-associated nephropathy (JCPyVAN) is a severe, but rare complication in adult renal transplant (RTx) recipients. Related data in pediatric patients are scarce.METHODS: Based on the CERTAIN Registry, we therefore performed a multi-center, retrospective study on the JCPyV antibody status, prevalence of JCPyV replication, and its associated disease in 139 pediatric RTx recipients (mean age, 8.5 ± 5.3 years). JCPyV DNA in plasma and/or urine was measured by quantitative PCR at a median time of 3.2 (IQR, 0.3-8.1) years post-transplant.RESULTS: 53.2% of patients were JCPyV-seronegative prior to transplantation; younger age was associated with JCPyV seronegativity. 34/139 (24.5%) patients post-transplant showed active JCPyV replication in either urine (22.0%), plasma (13.4%), or both (7.6%). JCPyV viremia occurred significantly (p < 0.001) more often in patients with viruria (34.6%) than in those without (7.6%), but 7/118 (5.9%) had isolated viremia. High-level viruria (> 107 copies/mL) was found in 29.6% of viruric patients. A higher net state of immunosuppression constituted an independent risk factor for JCPyV replication both in urine and plasma (OR 1.2, p < 0.02). Male patients tended to have a higher risk of JCPyV viremia than females (OR 4.3, p = 0.057). There was one male patient (0.7%) with JCPyVAN 7 years post-transplant, which resolved after reduction of immunosuppressive therapy. No patient exhibited progressive multifocal leukoencephalopathy.CONCLUSIONS: This first multi-center study on JCPyV in pediatric renal transplant recipients shows that JCPyV replication is common (24.5%), with strong immunosuppression being a significant risk factor, but associated nephropathy is rare.
KW - Journal Article
U2 - 10.1007/s00467-018-4029-9
DO - 10.1007/s00467-018-4029-9
M3 - SCORING: Journal article
C2 - 30058047
VL - 33
SP - 2343
EP - 2352
JO - PEDIATR NEPHROL
JF - PEDIATR NEPHROL
SN - 0931-041X
IS - 12
ER -