Is BK Viral Subtype Distribution of Donor And/Or Recipient Important for Subsequent BK Viral Infection After Living-Donor Transplantation?

A. Schwarz,¹ S. Linnenweber-Held,¹ H. Haller,¹ A. Heim,² C. Schmitt.²

¹Nephrology, Hannover Medical School, Hannover, Germany
²Virology, Hannover Medical School, Hannover, Germany.

Meeting: 2015 American Transplant Congress

Abstract number: 428

Keywords: Graft function, Infection, Kidney transplantation, Polyma virus

Session Information

Session Name: Concurrent Session: BK Virus Infection After Kidney Transplantation

Session Type: Concurrent Session

Date: Tuesday, May 5, 2015

Session Time: 4:00pm-5:30pm

Presentation Time: 4:24pm-4:36pm

Location: Room 115-C

Background: Source and risk factors for developing BK virus (BKV) infection after renal transplantation are unresolved. By genotyping of urine and blood, we looked for a prevalence of certain BKV subtypes in post-transplant recipients developing relevant BKV infection defined as BKV nephropathy or high viremia of >10⁴ copies/mL.

Patients and Methods: In a cohort of 214 donor-recipient pairs during living-donor transplantation, we tested urine and blood by qPCR for the presence of BKV DNA (Cepheid-Affigene Kit). In positive cases, genotyping of the BKV subtype was performed in the urine of spontaneous BKV replicating donors and recipients before and urine and blood of the infected recipients after transplantation.

Results: In 40/66 (61%) donors and recipients with BKV DNA shedding before, and in 75/85 (88%) infected recipients after transplantation, BKV genotyping was possible. Fifty-two of 214 donors (24%) and 29 of 197 recipients (15%) had BKV viruria before transplantation (in 15 cases both). Eighty-five of 214 recipients (40%) developed either BKV viruria alone (n=24) or viruria combined with viremia (61) after transplantation. Twentytwo of the patients with viruria/viremia additionally had biopsy-proven BKV nephropathy (22/214 recipients, 10%). Viremia of ≥10⁴ copies/mL was seen in 10 other patients (10/214, 5%) without biopsy-confirmed BKV nephropathy (SV40 negative biopsy in 4, refusal of biopsy in 6 patients). Subtype Ib-2 was the most prevalent subtype in all patient groups (55-73%). After transplantation, subtype IV occured more often in patients with post-transplant BKV nephropathy or high viremia of 10⁴ copies/mL than in others (n=10/32* vs 5/43, p=0.04).

Conclusion: BKV subtype IV may be one of the viral determinants of relevant post-transplant BKV infection.

BKV subtype distribution (*relevant BKV infection)
BKV subtype	Donor pre-Tx	Recipient pre-Tx	Redipient post-Tx with BKVN	Recipient post-Tx with viremia >10000 c/mL	Recipient post-Tx with viremia <10000 c/mL
	n=29 (%)	n=11 (%)	n=22 (%)	n=10 (%)	n=43 (%)
Ib-1	3 (10%)	1 (9%9	1 (5%)	0	5 (12%)
Ib-2	16 (55%)	8 (73%)	12 (55%)	7 (70%)	30 (70%)
II	3 (10%)	1 (9%)	1 (5%)	0	3 (7%)
III	0	0	1 (5%)	0	0
IV	7 (24%)	1 (9%)	7 (32%)*	3 (30%)*	5 (12%)

(Pre-Tx = before, post-Tx = after transplantation; BKVN=BkV nephropathy)

To cite this abstract in AMA style:

Schwarz A, Linnenweber-Held S, Haller H, Heim A, Schmitt C. Is BK Viral Subtype Distribution of Donor And/Or Recipient Important for Subsequent BK Viral Infection After Living-Donor Transplantation? [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/is-bk-viral-subtype-distribution-of-donor-andor-recipient-important-for-subsequent-bk-viral-infection-after-living-donor-transplantation/. Accessed May 13, 2025.

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