Risk factors and outcomes of BK viremia among deceased donor kidney transplant recipients based on donor characteristics

• Published in: Transplant infectious disease Vol. 24; no. 1; pp. e13768 - n/a
• Main Authors: Breyer, Isabel, Dodin, Ban, Djamali, Arjang, Jorgenson, Margaret R., Garg, Neetika, Aziz, Fahad, Mohamed, Maha A., Mandelbrot, Didier A., Parajuli, Sandesh
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01.02.2022
• Subjects: Adult; BK Virus; Body mass; Body mass index; Body size; Confidence intervals; Discordance; donor factors; Graft rejection; Grafts; Humans; Impact analysis; Infections; Kidney transplantation; Kidney Transplantation - adverse effects; Kidney transplants; Kidneys; Nephropathy; Organ donors; outcomes; Polyomavirus Infections - epidemiology; recipients factors; Risk analysis; Risk Factors; Transplant Recipients; Transplants; Tumor Virus Infections - epidemiology; Viremia; Viremia - epidemiology; BK virus; outcomes; donor factors; recipients factors
• ISSN: 1398-2273; 1399-3062
• DOI: 10.1111/tid.13768

Introduction BK polyomavirus (BKV) is a common infection among kidney transplant recipients (KTR). Risk factors and outcomes based on donor characteristics remain largely unknown. Methods In this study, we aimed to analyze the impact of donor factors through a paired kidney analysis. We included 289 pairs of adult deceased donor transplants (578 KTRs total); each pair had received kidneys from the same donor. Recipient pairs were divided into three groups: “no BK group” if neither KTR developed BK viremia (n = 336), “discordant” if the only one did (n = 176), and “concordant” if both did (n = 66). Acute rejection (AR), graft failure, and BK nephropathy (BKN) were outcomes of interest. Results Donors in the concordant group were younger, had lower kidney donor profile index (KDPI), and were less likely to be donor after circulatory death (DCD). In multivariate analyses, KTRs who had a donor with a higher body mass index (BMI) (hazard ratio (HR): 0.97; 95% confidence interval (CI): 0.95–0.99; p = .009) were less likely to develop BKV. Concordance was not associated with AR (HR: 0.83; 95% CI: 0.51–1.34; p = .45), graft failure (HR: 1.77; 95% CI: 0.42–7.50; p = .43), or BKN (HR: 1.02; 95% CI: 0.51–2.03; p = .96). Discussion Our study suggests lower donor BMI is associated with BKV infection, and concordance or discordance between paired kidney recipients is not associated with poor outcomes.