Influence of the Tacrolimus Metabolism Rate on BKV Infection After Kidney Transplantation.

G. Thölking,¹ C. Schmidt,¹ K. Schuette-Nuetgen,¹ D. Pabst,¹ R. Koch,² H. Wolters,³ S. Reuter,¹ B. Suwelack.¹

¹Department of Medicine D, Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Münster, Münster, Germany
²Institute of Biometrics and Clinical Research, University of Münster, Münster, Germany
³Department of General Surgery, University Hospital of Münster, Münster, Germany.

Meeting: 2016 American Transplant Congress

Abstract number: 436

Keywords: FK506, Immunosuppression, Polyma virus, Risk factors

Session Information

Session Name: Concurrent Session: Kidney: Polyomavirus

Session Type: Concurrent Session

Date: Tuesday, June 14, 2016

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

Presentation Time: 3:06pm-3:18pm

Location: Room 210

Introduction: BK virus (BKV) infection is a serious complication following renal transplantation (RTx). The minimization of risk factors that predict BKV infection might help to prevent BKV associated nephropathy (BKN). Given that immunosuppression promotes BKV infection, we hypothesized an association between tacrolimus (Tac) metabolism rate and BKV infection.

Patients and Methods: RTx patients with BK viremia (BKV group) were compared with BKV negative recipients that presented at our transplant centre. The Tac metabolism rate expressed as the blood concentration normalized by the daily dose (C/D ratio) was used to assess the Tac metabolism rate. Tac trough blood levels, daily Tac doses and prednisolone doses were analyzed at 1, 3 and 6 months after RTx.

Results: 96 BKV positive patients were compared with 96 BKV negative controls. BKV was detected after a median time of 4 (0-64) months after RTx. The BKV group was older (54.4±13.2 vs. 50.3±14.7; P=0.045) and included more CMV high risk patients (D+/R-) (29.2% vs. 9.4%; P=0.0007). BKV positivity was associated with a lower Tac C/D ratio (fast metabolizers) at 1, 3 and 6 months after RTx (P=0.0008; P=0.0202; P=0.0005, respectively). Mean Tac trough levels were lower 1 and 6 months after RTx in the BKV group (P=0.0024; P=0.0013, respectively). Mean daily Tac doses did not differ noticeably between the groups. As a known inductor of Tac metabolism, the prednisolone dose was noticeably higher in patients with BKV infection 3 months after RTx (P=0.0098). Using logistic regression analysis, age, CMV high risk status and fast Tac metabolism were associated with BKV infection. 9.4% of all BKV positive patients revealed histologically proven BKN.

Conclusion: We conclude from our data that recipient age, CMV high risk status and faster Tac metabolism are associated with BKV infection after RTx. The Tac C/D ratio should be taken into account in BKV risk stratification.

CITATION INFORMATION: Thölking G, Schmidt C, Schuette-Nuetgen K, Pabst D, Koch R, Wolters H, Reuter S, Suwelack B. Influence of the Tacrolimus Metabolism Rate on BKV Infection After Kidney Transplantation. Am J Transplant. 2016;16 (suppl 3).

To cite this abstract in AMA style:

Thölking G, Schmidt C, Schuette-Nuetgen K, Pabst D, Koch R, Wolters H, Reuter S, Suwelack B. Influence of the Tacrolimus Metabolism Rate on BKV Infection After Kidney Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/influence-of-the-tacrolimus-metabolism-rate-on-bkv-infection-after-kidney-transplantation/. Accessed November 22, 2024.

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