Volume 23, Issue 1 e13324

ORIGINAL ARTICLE

BK polyomavirus viremia and antibody responses of pediatric kidney transplant recipients in Finland

Jenni Miettinen,

Corresponding Author

Jenni Miettinen

[email protected]

orcid.org/0000-0003-4141-4878

Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

Correspondence

Jenni Miettinen, Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Email: [email protected]

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Irmeli Lautenschlager,

Irmeli Lautenschlager

Department of Virology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

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Fabian Weissbach,

Fabian Weissbach

Transplantation & Clinical Virology, Department of Biomedicine, University of Basel, Basel, Switzerland

Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Basel, Switzerland

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Marion Wernli,

Marion Wernli

Transplantation & Clinical Virology, Department of Biomedicine, University of Basel, Basel, Switzerland

Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Basel, Switzerland

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Eeva Auvinen,

Eeva Auvinen

Department of Virology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

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Laura Mannonen,

Laura Mannonen

Department of Virology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

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Jouni Lauronen,

Jouni Lauronen

Histocompatibility Laboratory, Finnish Red Cross Blood Service, Helsinki, Finland

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Hans H. Hirsch,

Hans H. Hirsch

Transplantation & Clinical Virology, Department of Biomedicine, University of Basel, Basel, Switzerland

Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Basel, Switzerland

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Hannu Jalanko,

Hannu Jalanko

Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

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Jenni Miettinen,

Corresponding Author

Jenni Miettinen

[email protected]

orcid.org/0000-0003-4141-4878

Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

Correspondence

Jenni Miettinen, Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Email: [email protected]

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Irmeli Lautenschlager,

Irmeli Lautenschlager

Department of Virology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

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Fabian Weissbach,

Fabian Weissbach

Transplantation & Clinical Virology, Department of Biomedicine, University of Basel, Basel, Switzerland

Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Basel, Switzerland

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Marion Wernli,

Marion Wernli

Transplantation & Clinical Virology, Department of Biomedicine, University of Basel, Basel, Switzerland

Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Basel, Switzerland

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Eeva Auvinen,

Eeva Auvinen

Department of Virology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

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Laura Mannonen,

Laura Mannonen

Department of Virology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

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Jouni Lauronen,

Jouni Lauronen

Histocompatibility Laboratory, Finnish Red Cross Blood Service, Helsinki, Finland

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Hans H. Hirsch,

Hans H. Hirsch

Transplantation & Clinical Virology, Department of Biomedicine, University of Basel, Basel, Switzerland

Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Basel, Switzerland

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Hannu Jalanko,

Hannu Jalanko

Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

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First published: 16 November 2018

https://doi.org/10.1111/petr.13324

Citations: 9

Hirsch and Jalanko contributed equally.

Funding information

The study was supported by the grants of the Helsinki University Hospital Funds (IL and HJ) and Pediatric Research Funds (HJ) and by an unrestricted appointment grant of the University of Basel (HHH).

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Abstract

Background

BKPyV is an important cause of premature graft failure after KT. Most clinical studies describe BKPyV infection in adult KT patients. We studied the prevalence of post-transplant BKPyV viremia, serology, and graft function in pediatric KT recipients.

Methods

Forty-six pediatric patients transplanted between 2009 and 2014 were followed up for BKPyV DNAemia by plasma PCR for median 2.3 (range: 1-6) years. BKPyV-specific antibodies were retrospectively analyzed using virus-like particle ELISA. GFR was measured annually by ⁵¹Cr-EDTA clearance, and serum samples were screened for DSAs by Luminex assay.

Results

BKPyV viremia was demonstrated in nine patients at a median of 6 months post-KT. Early BKPyV viremia at 3 months post-KT associated with decreased concomitant GFR and tendency for decreased subsequent graft function. Three of nine patients with BKPyV viremia developed DSA, all against class II antigens. PyVAN developed to four patients and responded to judicious reduction in IS. One graft was lost later due to ABMR. BKPyV-IgG was found in 18 of 31 patients (58%) tested at transplantation, and seven recipients seroconverted after transplantation with a significant increase in IgG levels with IgM. Finally, BKPyV-IgG was detectable in 31 of 40 patients (78%) at the end of the study.

Conclusions

Post-transplant BKPyV viremia in pediatric KT patients may alter graft function and contribute to progression of chronic allograft injury. BKPyV-IgG predicts past exposure. Low or absent BKPyV-specific antibody levels were seen pretransplant in 42% of tested patients, but were not predictive of prolonged replication or poor outcome.

CONFLICT OF INTERESTS

The authors declare no conflict of interests.

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Volume23, Issue1

February 2019

e13324

BK polyomavirus viremia and antibody responses of pediatric kidney transplant recipients in Finland

Abstract

Background

Methods

Results

Conclusions

CONFLICT OF INTERESTS

REFERENCES

Citing Literature

References

Information

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BK polyomavirus viremia and antibody responses of pediatric kidney transplant recipients in Finland

Abstract

Background

Methods

Results

Conclusions

CONFLICT OF INTERESTS

REFERENCES

Citing Literature

References

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