Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: Seropositivity for polyoma virus can reach 80% in kidney transplant recipients, with 1 to 10% polyoma associated nephropathy which negatively influences graft survival. Therefore, monitoring infection is of paramount importance. This study describes the incidence of BK virus infection in renal transplant recipients and verifies the correlation with two immunosuppressive regimens, tacrolimus (TAC) and a mTOR inhibitor (mTORi) or tacrolimus (TAC) and sodium mycophenolate (SM).
*Methods: This is a prospective study that evaluated consecutive kidney transplant recipients from September 2017 to September 2018 with in house real-time PCR for polyoma virus DNA in plasma samples. Samples were taken monthly for the first 3 months and then at 6, 9 and 12 months. Plasma samples were classified as high risk (> 10,000 copies/mL), medium risk (1,000 to <10,000 copies/mL) and low risk <1,000 copies/mL).
*Results: Two hundred and fifty-eight blood samples from 67 kidney transplant recipients were obtained in the period. Most patients (78%) received a kidney from a deceased donor. Antithymocyte globulin induction was used in 69%. Maintenance with TAC + SM was used in 56.7% and TAC + mTORi in 43.3%. All patients used prednisone at a maintenance dose of 5 mg per day. About 14% of plasma samples had more than 1,000 copies/mL of viral DNA at one month and 62% at 12 months. Considering those using TAC + MS, 31% had any sample with more than 1,000 copies/mL versus 17% of those using TAC + mTORi (p = 0,04). Concerning the more clinically relevant scenario of high risk for polyoma associated nephropathy among those with more than 10,000 copies/mL, 80% were using TAC + MS versus only 20% using TAC + mTORi. As for graft function those with more than 1,000 copies/mL had a mean creatinine of 3.12 mg/dL versus 2.24 mg/dL in those with no viremia or less than 1,000 copies/mL (p = 0,03).
*Conclusions: The incidence of polyoma viremia was higher at the end of the first year after transplantation. Polyoma viremia was more frequently observed in those using tacrolimus + mycophenolate. Viral replication was less intense in those using TAC + mTORi. Polyoma viremia was associated with worse graft function.
To cite this abstract in AMA style:Souza PM, Ribeiro C, Miranda SC, Alvarenga AS, Felipe CR, Marques G, Tarcia GP, Braga LL, Boy LSFerreira, Martins ML. Polyoma Virus Infection in Renal Transplant Recipients Using Tacrolimo and Everolimo [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/polyoma-virus-infection-in-renal-transplant-recipients-using-tacrolimo-and-everolimo/. Accessed October 26, 2020.
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