BK virus nephropathy in non‐renal solid organ transplant recipients: Are we looking hard enough?

• Published in: Clinical transplantation Vol. 35; no. 5; pp. e14265 - n/a
• Main Authors: Mallavarapu, Ravi K., Sanoff, Scott L., Howell, David N., Roberts, John K.
• Format: Journal Article
• Language: English
• Published: Denmark 01.05.2021
• Subjects: BK virus; immunosuppression; renal failure; solid organ transplant; renal failure; immunosuppression; BK virus; solid organ transplant
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/ctr.14265

We retrospectively examined the clinical characteristics, pathological features, and outcomes of BK viremia and nephropathy in a population of non‐renal solid organ transplant patients (NRSOT) referred for outpatient nephrology consultation over a period of 5 years. In the entire cohort of liver, heart, and lung transplant recipients referred to this clinic, 14% percent were found to have BK viremia with a median peak serum BK viral load of 35 500 copies/ml (range 250 to 21 100 000 copies/ml). BK viremia resolved in six of the seventeen patients (35%). Four out of five patients biopsied showed BK virus (BKV) nephropathy. Eleven out of seventeen patients with BK viremia developed advanced (stage 4 or 5) chronic kidney disease. Four patients developed rejection of their solid organ transplant within the first year post detection of BK viremia after immunosuppression reduction. We conclude that a multi‐center study is required to evaluate whether implementation of a systematic BK screening program would be effective in early detection and management of this problem in the NRSOT population.