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Long-term Prognosis of BK Virus Associated Nephropathy in Kidney Transplant Recipients

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Affiliated Author(s)
박성배한승엽박우영진규복강성식최미선
Alternative Author(s)
Park, Woo YoungKang, Seong SikJin, Kyu BokPark, Sung BaeChoe, Mi SunHan, Seung Yeup
Journal Title
Kidney Research and Clinical Practice
ISSN
2211-9132
Issued Date
2018
Keyword
BK virusGraft survivalKidney transplantationPrognosisRejection
Abstract
BACKGROUND:
The long-term prognosis of BK virus-associated nephropathy (BKVAN) in kidney transplant recipients (KTRs) is uncertain. We evaluated the long-term prognosis in KTRs with BKVAN and the clinical significance of BKVAN on post-transplant clinical outcome.

METHODS:
We retrospectively analyzed the medical records of 582 patients who underwent kidney transplant (KT) between 2001 and 2014. We divided the patients into a BKVAN group (15 patients) diagnosed by allograft biopsy and a control group (356 patients).

RESULTS:
The incidence of BKVAN was 4.0%, and the mean follow-up duration was 93.1 ± 52.3 months. Median time from KT to BKVAN diagnosis was 5.9 months (interquartile range [IQR], 4.4-8.7). In the BKVAN group, 9 (60.0%) KTRs with combined acute rejection progressed to graft failure, and the median time from BKVAN diagnosis to graft failure was 36.2 months (IQR, 9.7-65.5). Death-censored graft survival rate and patient survival rate in the BKVAN group were significantly lower than those in the control group. BKVAN and rejection were independent risk factors for graft failure. In the subgroup analysis, death-censored graft survival rate of KTRs with BKVAN with acute rejection was significantly worst in comparison with similar patients without BKVAN regardless of acute rejection (P < 0.001).

CONCLUSION:
The long-term prognosis of BKVAN with acute rejection was very poor because of graft failure caused by inadequate treatment for acute rejection considering BKVAN. Therefore, we should carefully monitor the allograft status of KTRs through regular surveillance tests after treatment for BKVAN with acute rejection.
Department
Kidney Institute (신장연구소)
Dept. of Internal Medicine (내과학)
Dept. of Pathology (병리학)
Publisher
School of Medicine (의과대학)
Citation
Woo Yeong Park et al. (2018). Long-term Prognosis of BK Virus Associated Nephropathy in Kidney Transplant Recipients. Kidney Research and Clinical Practice, 37(2), 167–173. doi: 10.23876/j.krcp.2018.37.2.167
Type
Article
ISSN
2211-9132
DOI
10.23876/j.krcp.2018.37.2.167
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41338
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
1. School of Medicine (의과대학) > Dept. of Pathology (병리학)
3. Research Institutues (연구소) > Kidney Institute (신장연구소)
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