Viral infection in transplant recipients increases risk of developing damaging antibodies

Such antibodies may increase the risk of rejection

2014-09-26

(Press-News.org) Washington, DC (September 25, 2014) — Kidney transplant recipients infected with BK virus are more likely to develop antibodies against their kidney transplants than uninfected patients, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). Future treatment strategies should focus on simultaneously clearing BK infections while protecting against risks of transplant rejection.

Many people are infected with BK virus, and it rarely causes disease. However, for transplant recipients and others who take immunosuppressive drugs, it can be problematic. The most common approach to BK infection in transplant patients is to reduce their anti-rejection medications so that their immune systems can fight off the infection. This of course could compromise the health of their transplanted organ.

Deirdre Sawinski, MD (Perelman School of Medicine at the University of Pennsylvania) and her colleagues looked at the health of 785 kidney transplant recipients, 132 of whom who had persistent BK infections despite reducing their anti-rejection medications.

While there was no significant difference in terms of patient or kidney transplant survival after a median of 3 years, patients with BK infections were more likely to develop antibodies against their kidney transplants. Such donor-specific antibodies are known to be detrimental to the survival of transplanted organs.

"This study is the first to link 2 common complications of kidney transplantation, namely BK viremia and donor-specific antibodies," said Dr. Sawinski. "However, we cannot comment on the exact mechanism by which BK viremia predisposes patients to the development of donor-specific antibodies."

INFORMATION: Study co-authors include Kimberly Forde, MD MSCE, Jennifer Trofe Clark, Pharm D, Priyanka Patel, BS, Beatriz Olivera BS, Simin Goral, MD, and Roy Bloom, MD.

Disclosures: The authors reported no financial disclosures.

The article, entitled "Persistent BK Viremia Does Not Increase Intermediate-Term Graft Loss But is Associated with De Novo Donor Specific Antibodies," will appear online at http://jasn.asnjournals.org/ on September 25, 2014.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, and with more than 14,000 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.

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