Incidence and Risks Factors of Kidney Allograft Loss Due to BK Virus in Pediatric Population: UNOS Data Set
1Transplant Nephrology, Beth Israel Deaconess Medical Center, Boston, MA, 2Nephrology (Medicine), Boston Children's Hospital, Boston, MA
Meeting: 2020 American Transplant Congress
Abstract number: A-071
Keywords: Graft failure, Pediatric, Polyma virus, Risk factors
Session Information
Date: Saturday, May 30, 2020
Session Name: Poster Session A: Kidney: Pediatrics
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: BK virus infection can lead to graft dysfunction and loss in kidney transplant patients. Incidence and prevalence of BK Viremia (BKV) and BK Virus Nephropathy (BKVN) have been evaluated previously in single center retrospective studies. 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 kidney transplant between January 2000 & December 2018 and compared risk factors of graft loss due to BKVN with functioning kidney graft (Table 1). Additional analysis was done to compare the risk factors between graft loss due other causes and due to BKVN. Baseline donor and recipient 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 were used to measure graft survival time between groups.
*Results: A total of 62 (0.43%) patients suffered graft loss due to BKVN. African-American race, HLA mismatch ≥3, DR mismatch, less likely to be high risk EBV and higher cold-ischemia time were associated with BKVN graft loss [Table 1]. In comparison to graft loss due to other causes, male gender, HLA mismatch≥3 and use of tacrolimus at discharge was significantly associated with graft loss due to BKVN. Death censored median graft survival in BKVN group was less compared to graft loss due to other causes [1018 vs 1525 days][p=0.005]. Rate of retransplant was higher in the BKVN group compared to graft loss due to other causes [64.5% vs. 47.2%, p=0.007].
*Conclusions: Between the year 2000 and 2018 the incidence of graft loss due to BKVN in pediatric population was 0.43% in the UNOS data set. Our analysis suggests that BKVN is more prevalent during the first few years after transplant and is associated with early graft failure in Pediatric population.
| Total patients (14,233) | Functioning graft (10,532) | Due to BKVN (62) | p-value | Due to other causes (3,639) | Due to BKVN (62) | p-value |
| Age, Years (IQR) | 12(6-15) | 13(8-15) | 0.20 | 14 (9-16) | 13(8-15) | 0.20 |
| Gender, Male [%] | 60.6% | 71% | 0.09 | 53.5% | 71% | 0.006 |
| African American [%] | 15.4% | 24.2% | 0.05 | 27.3% | 24.2% | 0.58 |
| HLA Mismatch ≥3 % | 8236 (78.2) | 55 (88.7) | 0.04 | 3020 (82.9) | 55 (88.7) | 0.04 |
| DR Locus mismatch [2] % | 32.1% | 45.1% | 0.028 | 34.3% | 45.1% | 0.07 |
| Tacrolimus | 88.5 | 87.1 | 0.72 | 74.2 | 87.1 | 0.02 |
| Graft Survival Time {IQR | — | 1018 [585-1634] | — | 1525 [697- 2725] | 1018 [585-1634] | 0.005 |
To cite this abstract in AMA style:
Patel H, Agrawal K, Pawar A, Rodig N, Agrawal N, Cardarelli F. Incidence and Risks Factors of Kidney Allograft Loss Due to BK Virus in Pediatric Population: UNOS Data Set [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/incidence-and-risks-factors-of-kidney-allograft-loss-due-to-bk-virus-in-pediatric-population-unos-data-set/. Accessed April 20, 2021.« Back to 2020 American Transplant Congress