ArticleClinical transplantation2025
Long-Term Outcomes of BK Viremia in Kidney Transplant Recipients.
Article in Clinical transplantation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Incidence of BK Virus in HIV-positive Kidney Transplant Recipients: Case Series From South Africa.Transplantation direct · 2026Article
- Long-Term Outcomes of BK Viremia in Kidney Transplant Recipients.Clinical transplantation · 2025Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBK viremia is associated with worse kidney transplant function and de novo donor-specific antibodies (DSA), but mortality and graft survival are not impacted in the short- and intermediate-term. The long-term impact of BK viremia remains unclear.
methodsWe performed a single-center retrospective study on 1058 consecutive kidney or kidney-pancreas transplant recipients. We classified the cohort based on the presence or absence of BK viremia, BK viral loads, persistence of BK viremia, and pre-existing or de novo DSA. Outcomes included mortality, graft loss, death-censored graft survival (DCGS), estimated glomerular filtration rate, biopsy-proven acute rejection (BPAR), de novo DSA, ureteral stenosis, and genitourinary (GU) malignancies.
resultsOver a median follow-up period of 9.7 years, there was no difference in graft loss (p = 0.08) and mortality (p = 0.56). Time-varying multivariable analysis showed no difference in DCGS [HR 1.02, (0.91-1.16)]. Compared to never BK viremic patients, patients with BK viremia had similar graft function at 5 and 10 years (p = 0.09 and 0.65, respectively), rates of GU malignancies (7.0% vs. 5.2%, p = 0.35) and ureteral stenosis (0.8% vs. 0.4%, p = 0.63). Patients with BK viral loads >10 000 copies/mL had a higher risk of de novo DSA [HR 1.71, (1.08-2.68)] and BPAR [HR 2.11, (1.28-3.47)].
conclusionsBK viremia did not impact mortality, graft loss, kidney function, GU malignancies, and ureteral stenosis over long-term follow-up, but BPAR episodes and development of de novo DSA were higher with viral loads >10 000 copies/mL. Strict monitoring protocols and immunosuppression reduction strategies are effective in minimizing the risk associated with BK viremia.
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