Comparative Analysis of Risks Factors for Kidney Allograft Loss Due to Bk Nephropathy and Graft Loss Due to Other Causes: UNOS Data Set
1Transplant Nephrology, Beth Israel Deaconess Medical Center, Boston, MA, 2Transplant Nephrology, University of Missouri-Kansas City School of Medicine/Saint Luke's Health System, Kansas City, MO
Meeting: 2020 American Transplant Congress
Abstract number: 491
Keywords: Graft survival, Polyma virus, Risk factors
Session Information
Session Time: 3:15pm-4:45pm
Presentation Time: 3:15pm-3:27pm
Location: Virtual
*Purpose: 1-10% of the kidney transplant recipients develop BK virus nephropathy (BKVN). The risk factors associated with BKVN are not clearly understood. Here, we evaluate the incidence and risk factors of kidney allograft loss due to BKVN in the United Network for Organ Sharing (UNOS) data set.
*Methods: We conducted a retrospective cohort analysis of the kidney transplant UNOS database. We identified all patients who received a transplant between January 2000 & December 2018 and compared factors associated with graft loss due to BKVN with graft loss due to other causes. We evaluated the incidence trend of graft loss due to BKVN since the year 2000 and incidence among the pediatric population. Baseline donor, recipient, and kidney transplant characteristics were compared between groups using Student t-test or Kruskal Wallis test for continuous variables, and Chi-2 tests for categorical variables. Kaplan meier curve and log rank test was used to measure graft survival time between groups.
*Results: A total of 1392 (0.42%) patients suffered graft loss due to BKVN. Incidence of graft loss due to BKVN increased after year 2002, peaked during 2007-2009 and trended downward since 2010. Incidence of graft loss due to BKVN among the pediatric patients was slightly higher compared to adult population at 0.44% [p:0.003]. Table 1 shows the comparison of risk factors associated with the graft loss due to BKVN and other causes.
*Conclusions: In the BKVN group, patients lost their graft earlier than the comparison group [p<0.001]. Older age, male gender, HLA mismatch ≥3, longer dialysis vintage, preemptive transplant, deceased donor, induction with thymoglobulin, Campath and CMV high risk recipients were associated with graft loss due to BKVN as compared to graft loss from other causes.
| Total Transplants (332,649) | Failed due to other causes (56,319) | Failed due to BKVN (1,392) | p-value |
| Age, Years (IQR) | 45 (33-56) | 52(40-60) | <0.001 |
| Gender, Male | 58.7% | 72.2% | <0.001 |
| HLA mismatch (mean, SD) | 3.89 [1.62] | 4.27 [1.47] | <0.001 |
| Dialysis Vintage days | 981 [457-1757] | 1073 [503-1873] | 0.02 |
| Donor Type (deceased) % | 70.5 | 73.4 | 0.02 |
| DGF % | 26.6 | 19.76 | <0.001 |
| Thymoglobulin | 22,349(39.7) | 656 [47.1] | <0.001 |
To cite this abstract in AMA style:
Patel H, Kruger L, Agarwal K, Pawar A, Leeaphorn N, Cardarelli F, Agrawal N. Comparative Analysis of Risks Factors for Kidney Allograft Loss Due to Bk Nephropathy and Graft Loss Due to Other Causes: UNOS Data Set [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/comparative-analysis-of-risks-factors-for-kidney-allograft-loss-due-to-bk-nephropathy-and-graft-loss-due-to-other-causes-unos-data-set/. Accessed November 22, 2024.« Back to 2020 American Transplant Congress