Objectives: Allograft biopsy is the gold standard for diagnosing polyomavirus-associated nephropathy. We aimed to establish the effects of histopathologic findings proposed by the Banff Polyomavirus Working Group on graft outcome. We also aimed to understand the clinical importance of follow-up biopsies for patients with polyomavirus-associated nephropathy.
Materials And Methods: Our study included 22 patients with polyomavirus-associated nephropathy. All biopsies were classified according to the latest Banff Polyomavirus Working Group classification. Follow-up biopsies of all patients were evaluated in detail.
Results: The mean interval between polyomavirus-associated nephropathy and transplant was 10 ± 1.6 months. Of 22 patients, biopsy revealed stage 1 in 3 (13.6%), stage 2 in 17 (77.3%), and stage 3 in 2 patients (9.1%). Fourteen patients (63.6%) had polyomavirus viral load 3, 5 (22.7%) had polyomavirus viral load 2, and 3 had polyomavirus viral load 1. Among patients included in analyses, 18.2% had antibody-mediated rejection and 27.2% had T-cell-mediated rejection simultaneously with polyomavirus-associated nephropathy. Graft loss increased with increasing polyomavirus-associated nephropathy class and polyomavirus viral load (P = .015 and P = .002, respectively). The mean time of graft survival decreased with increasing degree of tubulitis, interstitial inflammation, plasma infiltration, and neutrophil infiltration. Patients with interstitial fibrosis, glomerular polyoma, and cortical plus medullar involvement showed earlier graft loss. Follow-up biopsies showed that diffuse interstitial fibrosis or persistent inflam-mation negatively influenced graft loss.
Conclusions: The Banff Polyomavirus Working Group's schema significantly correlated with graft outcome. Early detection of polyomavirus-associated nephro-pathy and subsequent detection of persistent inflammation and interstitial fibrosis and tubular atrophy in follow-up biopsies and modification of immunosuppressive therapy can successfully prevent graft loss.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.6002/ect.2023.0080 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Recent advances in discovery and functional analysis of the small proteins and microRNA expressed by polyomaviruses.
Virology
January 2025
Lewis Katz School of Medicine at Temple University, Department of Microbiology, Immunology and Inflammation Center for Neurovirology and Gene Editing, 3500 N. Broad Street, Philadelphia, PA, 19140, USA. Electronic address:
Article Synopsis
- * Some polyomaviruses can cause serious diseases such as polyomavirus-associated nephropathy, progressive multifocal leukoencephalopathy, trichodysplasia spinulosa, and Merkel cell carcinoma.
- * Recent research focuses on the functions of viral proteins and microRNA that these viruses express, shedding light on their role in viral biology, how they transform cells, and their potential impact on disease progression.
Serum and urine nucleic acid screening tests for BK polyomavirus-associated nephropathy in kidney and kidney-pancreas transplant recipients.
Cochrane Database Syst Rev
November 2024
Sydney School of Public Health, University of Sydney, Sydney, Australia.
Background: BK polyomavirus-associated nephropathy (BKPyVAN) occurs when BK polyomavirus (BKPyV) affects a transplanted kidney, leading to an initial injury characterised by cytopathic damage, inflammation, and fibrosis. BKPyVAN may cause permanent loss of graft function and premature graft loss. Early detection gives clinicians an opportunity to intervene by timely reduction in immunosuppression to reduce adverse graft outcomes.
View Article and Find Full Text PDFBK Polyomavirus DNAemia With a High DNA Load Is Associated With De Novo Donor-Specific HLA Antibodies in Kidney Transplant Recipients.
J Med Virol
November 2024
Department of Internal Medicine, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
Article Synopsis
- BK polyomavirus-associated nephropathy (BKPyVAN) is a significant complication after kidney transplantation, usually managed by reducing immunosuppression when BK polyomavirus (BKPyV) is detected.
- A study involving 1,076 kidney transplant recipients found a higher risk of developing de novo donor-specific antibodies (dnDSA) in patients with high BKPyV DNA loads compared to those without, suggesting that the required immunosuppression reduction can worsen immune responses.
- While high BKPyV DNAemia increased dnDSA risk, there was no significant difference in the occurrence of biopsy-proven acute rejection (BPAR) between groups, indicating a need for better strategies to manage BKPyV infections in transplant patients.
JC Polyomavirus Nephropathy: A Rare Complication Late after Kidney Transplantation.
Case Rep Nephrol Dial
August 2024
Division of Nephrology, Ente Ospedaliero Cantonale, Lugano, Switzerland.
Introduction: JC-polyomavirus-associated nephropathy (JC-PVAN) is a rare cause of allograft dysfunction with only a few cases described in the literature.
Case Presentation: We present 2 cases of JC-PVAN, both of which occurred >5 years after kidney transplantation. In both cases, transplant biopsies were performed because of worsening of kidney function.
Peritubular and Tubulointerstitial Inflammation as Predictors of Impaired Viral Clearance in Polyomavirus Nephropathy.
J Clin Med
September 2024
Department of Urology, Medical University of Vienna, 1090 Vienna, Austria.
Polyomavirus-associated nephropathy (BKPyVAN) is a common complication in kidney transplant recipients. The histological changes in the context of BKPyVAN and their association with the viral load and outcomes are still being investigated. This retrospective study involved 100 adult patients transplanted between 2000 and 2021, with available archived biopsy slides, aiming to analyze associations between viral load clearance in the blood (reduction in BKPyVAN-DNAemia below detection level) and histological features in biopsy-proven BKPyVAN.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!