ComplicationInfectionPolymerase Chain Reaction Detection of BK Virus and Monitoring of BK Nephropathy in Renal Transplant Recipients at the University Hospital La Fe
Section snippets
Subjects
Management of BK infection was based on the Nickeleit scheme.10 Samples were collected during the first posttransplantation year from 121 adult patients (75 males and 46 females; mean age, 48 years) and 11 pediatric patients (7 boys and 4 girls; mean age, 12 years).
First, we performed a monthly urinary cytology, namely between 1 and 11 cytologies with a mean of 5 per patient, looking for decoy or comet cells as a possible marker of viral replication. A urine aliquot was also frozen at −20°C.
Results
In this study, 132 consecutive kidney transplant recipients were monitored over 18 months using monthly urinary cytology, among which 23 (17.4%) showed at least 1 decoy cell in the urinary sample. The molecular study (PCR) revealed that 10 of 132 (7.5%) patients were PCR-serum–positive (7LT+/VP1− and 3 LT+/VP1+), and 13 of 40 (33%) were PCR-urine–positive (5LT+/VP1− and 8 LT+/VP1+). We confirmed the BKVN diagnosis using PCR on the renal biopsy specimen in 3 of 12 cases in which a biospsy was
Discussion
In the present study, BK-PCR assay for early detection of BK viral infection was performed on 132 recipients during the first posttransplantation year. In contrast to other previous BK-PCR assays,9, 10 we amplified 2 different BK genome regions (LT and VP1), seeking a more accurate BKV detection to avoid false-negative results due to viral genomic mutations, which prevent the primers from exactly matching with the complementary viral DNA, thus inhibiting the amplification of the BK target
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Cited by (19)
Noninvasive tool for the diagnosis of polyomavirus BK-associated nephropathy in renal transplant recipients
2013, Diagnostic Microbiology and Infectious DiseaseCitation Excerpt :Thus, urine cytology with quantitative counts can reflect not only BK viral load in vivo, but also renal histologic presentation indirectly. Furthermore, electron microscopy was used in this study to observe viral particles in the nucleus of sloughed tubular cells in order to confirm the presence of decoy cells because marked nuclear enlargement due to reactive and regenerative changes may closely resemble the PV cytopathic effect mentioned in the context of the research of Vera-Sempere et al. (2005). Also, electron microscopy studies may be useful for diagnosis and confirmation of PV infection based on the different ultrastructural morphology of the most common viral infections: adenovirus, herpesvirus, and CMV inclusions (Drachenberg et al., 2005).
Prospective Evaluation of BK Virus DNAemia in Renal Transplant Patients and Their Transplant Outcome
2007, Transplantation ProceedingsCitation Excerpt :The nonalteration of immunosuppression when the first BKV DNAemia occurred might explain why the prevalence of BKVAN was 3.8% in our cohort. However, these figures are similar to others found in the literature.6–13 The highest prevalence of BKV replication occurs between 2 to 6 months posttransplantation.4,11,14
Renal Donor Implication in the Origin of BK Infection: Analysis of Genomic Viral Subtypes
2006, Transplantation ProceedingsCitation Excerpt :Our management of BK infection is based on the Nickeleit scheme.10
Supported by FIS grant #C03/03 of the Organización Nacional de Transplantes (ONT) of Spain.