Ureteral stent placement and immediate graft function are associated with increased risk of BK viremia in the first year after kidney transplantation

作者：Maliakkal Joseph G; Brennan Daniel C; Goss Charles; Horwedel Timothy A; Chen Howard; Fong Dennis K; Agarwal Nikhil; Zheng Jie; Schechtman Kenneth B; Dharnidharka Vikas R^*

来源：Transplant International, 2017, 30(2): 153-161.

DOI：10.1111/tri.12888

• BK virus
• complications
• Infection
• kidney clinical
• kidney transplant
• outcome
• Polyoma
• surgery ureteral stent

Ureteral stent (UrSt) placement has been shown to be a significant independent risk factor for BK viruria, viremia, and BK virus nephropathy. We assessed whether this observation could be validated at our high volume kidney transplant center that has had a strong historical focus on BK virus nephropathy detection. We performed a retrospective case-control study of adults receiving a kidney-only transplant and followed for 1 year between 2004 and 2011 with uniform immunosuppression and use of blood BK virus PCR screening protocol. Among 1147 patients, 443 (38.6%) received a UrSt and 17.2% with a UrSt had BK viremia versus 13.5% without stent (odds ratio 1.33; 95% CI: 1.00-1.78). We confirmed a previously reported association between immediate graft IGF) and higher rate of BK viremia (15.7% vs. 5.9% in patients without IGF). On multivariable competing risks Cox regression in patients with IGF, UrSt (adjusted hazard ratio [aHR] 1.35; 95% CI: 1.04-1.75) and African American race (aHR 1.47; 95% CI: 1.04-2.09) significantly increased the risk for BK viremia. In the largest sample size to date, we confirmed that UrSt placement during kidney transplant surgery is a risk factor for BK viremia within the first year post-transplant and that IGF is associated with BK viremia.

• 出版日期2017-2