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Adverse Occurrence type:
Likely to be high but difficult to demonstrate.
Time to detection:
62 days (15 to 667 days)
Alerting signals, symptoms, evidence of occurrence:
In order to investigate de novo, donor-derived BKV infection versus reactivation of recipient pre-transplant strain in the post-transplant period, the authors performed this study in living kidney donor/recipient pairs. Blood and urine of living kidney donor and recipient pairs were tested for BKV DNA by polymerase chain reaction, before and after transplant. Detectable virus pre-transplant was correlated with the post-transplnat occurrence of BK viraemia and nephropathy.
Demonstration of imputability or root cause:
Urine of 249 living related donor/recipient pairs was investigated for the presence of BKV-DNA by qPCR before living transplantation (Tx) and consecutively after Tx. In 20 pairs, sequencing of the BKV VP1 typing region (TR) was successful. The derived sequences were completely identical in donor and post-Tx recipient samples. For comparison, identical TR sequences were detected in only 24% of 1068 randomly assembled pairs (p < 0.0001). Of note, intra familial rather than graft related BKV transmission cannot be excluded, as donors and recipients were close relatives or spouses.
Viral Origin, Clinical Course, and Renal Outcomes in Patients With BK Virus Infection After Living-Donor Renal Transplantation
Suggest new keywords:
BK nephropathy, viruria, viremia,
1) Schmitt, C. Raggub, L. Linnenweber-Held, S., Adams, O., Schwarz, A. and Heim, A. (2014). Donor origin of BKV replication after kidney transplantation. J Clin Virol 59(2):120-5. 2) Viral Origin, Clinical Course, and Renal Outcomes in Patients With BK Virus Infection After Living-Donor Renal Transplantation. Schwarz A et al. Transplantation. 2015 Dec 30 3) Wunderick et al. Pretransplantation Donor–Recipient Pair Seroreactivity Against BK Polyomavirus Predicts Viremia and Nephropathy After Kidney Transplantation. American Journal of Transplantation 2017; 17: 161–172