4.5 Article

Characterization of Kidney Retransplantation Following Graft Failure Due to BK Virus Nephropathy

期刊

JOURNAL OF SURGICAL RESEARCH
卷 269, 期 -, 页码 110-118

出版社

ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.jss.2021.07.047

关键词

BK virus; BK polyomavirus; BKVN; BKV nephropathy; Kidney transplantation; Retransplantation

类别

向作者/读者索取更多资源

Retransplantation following BKVN-associated graft failure has been associated with favorable outcomes, and to maximize allograft lifespan in retransplantation, clinicians may consider selection of low KDPI donors, prevention of delayed graft function, and tailored immunosuppressive regimens that minimize steroids.
Introduction: Immunosuppression following kidney transplantation increases risk of BK polyomavirus reactivation, a common cause of graft dysfunction and failure. Subsequent re transplantation is a viable option that has not been extensively studied. This study further characterizes BK Virus Nephropathy (BKVN) and retransplantation in the most expansive population to date, geographically, temporally, and in magnitude. Materials and Methods: The OPTN/UNOS database was used to identify patients who received kidney or kidney-pancreas transplantation between 1987 and 2018 that resulted in BKVN-attributed failure ( n = 1587). This population was divided into those who underwent retransplantation ( n = 495) and those who did not ( n = 1092). Results: The retransplanted cohort was younger (45 vs. 53 yr; P < 0.0001) and had fewer prior kidney transplants ( P < 0.003), lower expected post-transplant survival ( P < 0.001), lower rates of delayed graft function (DGF) (14.1% vs. 22.2%; P = 0.0008), a greater proportion of white patients (55.4% vs. 43.2%; P = 0.0002), a greater proportion of living donors (35.8% vs. 23.0%; P < 0.0001), and longer allograft lifespan (2.95 vs. 2.41 yr; P < 0.0001), compared to those not retransplanted. Among retransplants, DGF and high kidney donor profile index (KDPI) were associated with decreased allograft lifespan ( P = 0.001, P = 0.0005, respectively). Steroid induction had no effect on allograft lifespan when compared to steroid-free regimens ( P = 0.915). Retransplanted allografts lasted longer than previous BKVN-failed grafts (10.44 and 3.70 years, respectively; P < 0.0001). Conclusions: Retransplantation following BKVN-associated graft failure has been associated with favorable outcomes. To maximize allograft lifespan in retransplantation, clinicians may consider selection of low KDPI donors, prevention of delayed graft function, and tailored immunosuppressive regimens that minimize steroids. (c) 2021 Elsevier Inc. All rights reserved.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.5
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据