PMID- 24134704
OWN - NLM
STAT- MEDLINE
DCOM- 20141022
LR  - 20181202
IS  - 1399-3062 (Electronic)
IS  - 1398-2273 (Linking)
VI  - 16
IP  - 1
DP  - 2014 Feb
TI  - Association of BK viremia with human leukocyte antigen mismatches and acute 
      rejection, but not with type of calcineurin inhibitor.
PG  - 44-54
LID - 10.1111/tid.12153 [doi]
AB  - INTRODUCTION: BK viremia and polyomavirus-associated nephropathy (PVN) represent 
      a significant problem after kidney transplantation. Both are associated with 
      intensified immunosuppression, but other risk factors and the impact of a 
      screening program on outcome are incompletely understood. METHODS: Here, we 
      report on the short- and long-term outcome of a cohort of patients, who were 
      transplanted in 2006/2007 and included in a newly introduced systematic 3-monthly 
      screening for BK viremia at the University Hospital Zurich. In patients testing 
      positive for BK viremia, screening frequency was intensified and 
      immunosuppression reduced. Patients with suspected PVN underwent transplant 
      biopsy. RESULTS: Among 152 included patients, 49 (32%) tested positive for BK 
      viremia, but only 8 developed biopsy-proven PVN. BK viremia had a significant 
      impact on estimated glomerular filtration rate and proteinuria in the first 2 
      years. Acute rejection episodes and the number of human leukocyte antigen (HLA) 
      mismatches were the strongest independent predictors of BK viremia in a multiple 
      logistic model. In contrast, no particular immunosuppressive agent or regimen was 
      associated with enhanced risk. CONCLUSION: Taken together, systematic BK viremia 
      screening led to detection of a high percentage of viremic patients. With 
      adjustment of immunosuppression, an excellent outcome was achieved. The 
      independent association of HLA mismatches with BK viremia suggests impaired 
      polyomavirus immunosurveillance in highly mismatched allografts.
CI  - (c) 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Hassig, A
AU  - Hassig A
AD  - Division of Nephrology, University Hospital Zurich, Zurich, Switzerland.
FAU - Roos, M
AU  - Roos M
FAU - Etter, A
AU  - Etter A
FAU - Bossart, W
AU  - Bossart W
FAU - Muller, N
AU  - Muller N
FAU - Schiesser, M
AU  - Schiesser M
FAU - Wuthrich, R P
AU  - Wuthrich RP
FAU - Fehr, T
AU  - Fehr T
LA  - eng
PT  - Journal Article
DEP - 20131018
PL  - Denmark
TA  - Transpl Infect Dis
JT  - Transplant infectious disease : an official journal of the Transplantation 
      Society
JID - 100883688
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (HLA Antigens)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Pyrroles)
RN  - 0 (Quinazolines)
RN  - 0 (Recombinant Fusion Proteins)
RN  - 7I279E1NZ8 (sotrastaurin)
RN  - 83HN0GTJ6D (Cyclosporine)
RN  - 9927MT646M (Basiliximab)
RN  - HU9DX48N0T (Mycophenolic Acid)
RN  - MRK240IY2L (Azathioprine)
RN  - WM0HAQ4WNM (Tacrolimus)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Allografts/*immunology
MH  - Antibodies, Monoclonal/therapeutic use
MH  - Azathioprine/therapeutic use
MH  - *BK Virus
MH  - Basiliximab
MH  - Cohort Studies
MH  - Cyclosporine/therapeutic use
MH  - Female
MH  - Glomerular Filtration Rate
MH  - Graft Rejection/*immunology/prevention & control
MH  - HLA Antigens/immunology
MH  - Histocompatibility/*immunology
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Kidney Diseases/*immunology/virology
MH  - *Kidney Transplantation
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Mycophenolic Acid/analogs & derivatives/therapeutic use
MH  - Polyomavirus Infections/*immunology
MH  - Proteinuria/immunology
MH  - Pyrroles/therapeutic use
MH  - Quinazolines/therapeutic use
MH  - Recombinant Fusion Proteins/therapeutic use
MH  - Tacrolimus/therapeutic use
MH  - Tumor Virus Infections/*immunology
MH  - Viremia/*immunology
OTO - NOTNLM
OT  - BK nephropathy
OT  - BK virus
OT  - HLA matching
OT  - acute rejection
OT  - immunosuppression
OT  - kidney transplantation
OT  - polyomavirus-associated nephropathy
EDAT- 2013/10/19 06:00
MHDA- 2014/10/23 06:00
CRDT- 2013/10/19 06:00
PHST- 2013/02/01 00:00 [received]
PHST- 2013/03/31 00:00 [revised]
PHST- 2013/04/21 00:00 [accepted]
PHST- 2013/10/19 06:00 [entrez]
PHST- 2013/10/19 06:00 [pubmed]
PHST- 2014/10/23 06:00 [medline]
AID - 10.1111/tid.12153 [doi]
PST - ppublish
SO  - Transpl Infect Dis. 2014 Feb;16(1):44-54. doi: 10.1111/tid.12153. Epub 2013 Oct 
      18.