Urine Donor-derived Cell-free is Valuable for Predicting BK Polyomavirus-associated Nephropathy in Kidney Transplant Recipients

G. Huang¹, X. Chen¹, Y. Huang¹, J. Li¹, R. Deng¹, W. Chen², J. Qiu¹, S. Deng¹, G. Chen¹, Q. Fu¹, C. Wu¹, J. Fei¹, L. Liu¹, L. Chen¹, C. Wang¹

¹Organ Transplant Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China, ²Department of Pathology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

Meeting: 2021 American Transplant Congress

Abstract number: 982

Keywords: Kidney transplantation, Polyma virus, Rejection, Renal injury

Topic: Clinical Science » Kidney » Kidney Technical

Session Information

Session Name: Kidney Technical

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: Our previous study has proved that urine donor-derived cell-free DNA (dd-cfDNA) can assist in the diagnosis of BK polyomavirus-associated nephropathy (BKPyVAN), but its specificity is not clear. This prospective study was designed to evaluate the relationship between urine dd-cfDNA and various types of pathological damages in the transplanted kidney.

*Methods: Urine dd-cfDNA quantification and proportion were respectively assayed from 96 patients receiving kidney transplant biopsies in our center. Dd-cfDNA was detected through Target Region Capture Sequencing and reads were calculated by Maximum Likehood Estimation.

*Results: There was no significant difference in urine dd-cfDNA proportion among all groups (Figure 1A). Urine dd-cfDNA quantification was significantly higher in BKVN than Mixed-rejection (P=0.020), Borderline rejection (P=0.020), IgAN (P<0.001), IF/TA (P=0.003), and FSGS (P=0.042) (Figure 1B).

Receiver operating characteristic (ROC) analysis showed that the optimal cut-off value of urine dd-cfDNA quantification for predicting BKPyVAN was 6.08, with an area under the ROC curve (AUC) of 0.804 (95% confidence interval [CI]: 0.771-0.878) (Figure 2A). Youden index, sensitivity and specificity were 0.459, 0.778 and 0.681 respectively. ROC analysis exhibited that the optimal cut-off value of urine dd-cfDNA proportion for predicting BKPyVAN was 5.93%, with an AUC of 0.670 (95% CI: 0.566-0.762) (Figure 2B). Youden index, sensitivity and specificity were 0.340, 0.630 and 0.710 respectively.

*Conclusions: Urine dd-cfDNA quantification was significantly increased in transplanted kidney with BKPyVAN. Urine dd-cfDNA has diagnostic value in predicting BKPyVAN.

To cite this abstract in AMA style:

Huang G, Chen X, Huang Y, Li J, Deng R, Chen W, Qiu J, Deng S, Chen G, Fu Q, Wu C, Fei J, Liu L, Chen L, Wang C. Urine Donor-derived Cell-free is Valuable for Predicting BK Polyomavirus-associated Nephropathy in Kidney Transplant Recipients [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/urine-donor-derived-cell-free-is-valuable-for-predicting-bk-polyomavirus-associated-nephropathy-in-kidney-transplant-recipients/. Accessed May 11, 2025.

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