02342nas a2200277   4500008003900000245014500039210006900184260000800253300000600261490000700267520152600274100001801800700002301818700003101841700001501872700001701887700001701904700001401921700001801935700001401953700001401967700000501981700001601986700001702002856004502019       2017                          d00aPretransplantation Donor-Recipient Pair Seroreactivity Against BK Polyomavirus Predicts Viremia and Nephropathy After Kidney Transplantation0 aPretransplantation DonorRecipient Pair Seroreactivity Against BK  cJan  a60 v173 aKidney transplant donors are not currently implicated in predicting BK polyomavirus (BKPyV) infection in kidney transplant recipients. It has been postulated, however, that BKPyV infection originates from the kidney allograft. Because BKPyV seroreactivity correlates with BKPyV replication and thus might mirror the infectious load, we investigated whether BKPyV seroreactivity of the donor predicts viremia and BKPyV-associated nephropathy (BKPyVAN) in the recipient. In a retrospective cohort of 407 living kidney donor-recipient pairs, pretransplantation donor and recipient sera were tested for BKPyV IgG levels and correlated with the occurrence of recipient BKPyV viremia and BKPyVAN within 1 year after transplantation. Donor BKPyV IgG level was strongly associated with BKPyV viremia and BKPyVAN (p < 0.001), whereas recipient BKPyV seroreactivity showed a nonsignificant inverse trend. Pairing of high-BKPyV-seroreactive donors with low-seroreactive recipients resulted in a 10-fold increased risk of BKPyV viremia (hazard ratio 10.1, 95% CI 3.5-29.0, p < 0.001). In multivariate analysis, donor BKPyV seroreactivity was the strongest pretransplantation factor associated with viremia (p < 0.001) and BKPyVAN (p = 0.007). The proportional relationship between donor BKPyV seroreactivity and recipient infection suggests that donor BKPyV seroreactivity reflects the infectious load of the kidney allograft and calls for the use of pretransplantation BKPyV serological testing of (potential) donors and recipients.1 aWunderink, HF1 avan der Meijden, E1 ade Brouwer, CS, van der Bl1 aMallat, MJ1 aHaasnoot, GW1 avan Zwet, EW1 aClaas, EC1 ade Fijter, JW1 aKroes, AC1 aArnold, F1 a1 aRotmans, JI1 aFeltkamp, MC  uhttps://notifylibrary.org/reference/4746