Comparison of Recipients with Early and Late Presenting Polyomavirus Nephropathy (PVN) with Regard to Histological Findings and Graft Survival: What is the Influence of CD4/CD8 Ratio on the Presenting Time of PVN

B. Ozdemir,¹ S. Ayva,¹ A. Terzi,¹ A. Ok Atilgan,¹ E. Akcay,¹ E. Ayvazoglu Soy,² F. Ozdemir,³ M. Haberal.²

¹Pathology, Baskent University, Ankara, Turkey
²Transplantation, Baskent University, Ankara, Turkey
³Nephrology, Baskent University, Ankara, Turkey.

Meeting: 2018 American Transplant Congress

Abstract number: 464

Keywords: Graft survival, Polyma virus

Session Information

Session Name: Concurrent Session: Kidney: Polyoma

Session Type: Concurrent Session

Date: Tuesday, June 5, 2018

Session Time: 2:30pm-4:00pm

Presentation Time: 3:30pm-3:42pm

Location: Room 2AB

Introduction: PVN is a common complication occurring around 12 mo after renal transplant (RT). We aimed to explore the differences between early and late-onset PVN with regard to histological findings and graft survival.

Methods: Indications and follow-up biopsies of 71 patients with PVN were reevaluated and examined for development of interstitial fibrosis (IF). Interstitial plasma cells, neutrophils, CD3, CD4, CD8, HLA-DR positive cells, and macrophages were graded. Patients were separated into 4 groups based on time of development of PVN after RT [Group A: <12mo (n=35), Group B: 12-24mo (n=13), Group C: 24-48mo (n=15), Group D: >48mo (n=8)]. Also, they were correlated in 2 groups: Group 1 (n=48) early PVN (≤12mo) and Group 2 (n=23) late PVN (>12mo)

Results: The mean interval between the diagnosis of PVN and RT was 17±22 months. Group 1 had higher mean hemodialysis (HD) time before RT (p<.05). CMV viremia was also found in 27 patients. The mean viral load in urine and plasma at diagnosis was higher in Group 1 (p<.01).Group 1 showed lower stages and higher degrees of polyoma viral load (Pvl) in biopsy (p<.05). Viral load in urine, plasma, and biopsy increased from Group A to D. Group 1 showed higher degrees of interstitial neutrophil, plasma, macrophage, lymphocyte, DR-positive cell infiltration and lower degrees of the CD4/CD8 ratio (p<.01). All inflammatory cell types increased from Group A to D. Interstitial CD4/CD8 ratio showed a significant negative correlation with Pvl (r=-0.320, p=.01), viremia (r=-0.602, p<.001) and viruria (r=-0.748, p<.001). 43 patients (60.6%) developed IF during follow-up, and 31 (43.7%) lost their graft 18±14mo after PVN. The risk of development of IF increased from Group A to D (p<.01).Compared to Group 2 (28.7±16mo), mean time of graft loss after PVN was earlier in Group 1 (13.3±9mo). The mean time of graft loss also decreased from group A to D (p<.05). Positive correlation was found between graft loss and CD4/CD8 ratio (r=0.391, p<.05).

Conclusion: Recipients with late-onset PVN had a better prognosis than early-onset cases. Host cells may influence the time of PVN onset. Lower CD4 and higher CD8 proportions were risk factors for early-onset PVN and poor graft survival.

CITATION INFORMATION: Ozdemir B., Ayva S., Terzi A., Ok Atilgan A., Akcay E., Ayvazoglu Soy E., Ozdemir F., Haberal M. Comparison of Recipients with Early and Late Presenting Polyomavirus Nephropathy (PVN) with Regard to Histological Findings and Graft Survival: What is the Influence of CD4/CD8 Ratio on the Presenting Time of PVN Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Ozdemir B, Ayva S, Terzi A, Atilgan AOk, Akcay E, Soy EAyvazoglu, Ozdemir F, Haberal M. Comparison of Recipients with Early and Late Presenting Polyomavirus Nephropathy (PVN) with Regard to Histological Findings and Graft Survival: What is the Influence of CD4/CD8 Ratio on the Presenting Time of PVN [abstract]. https://atcmeetingabstracts.com/abstract/comparison-of-recipients-with-early-and-late-presenting-polyomavirus-nephropathy-pvn-with-regard-to-histological-findings-and-graft-survival-what-is-the-influence-of-cd4-cd8-ratio-on-the-presenting/. Accessed June 2, 2025.

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