Clinical factors of BK polyomavirus in kidney transplantation – UROP Spring Symposium 2021

Clinical factors of BK polyomavirus in kidney transplantation

Madeline Vincent

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Pronouns: she/her

Research Mentor(s): Evan Farkash, Assistant Professor
Research Mentor School/College/Department: Department of Pathology, Michigan Medicine
Presentation Date: Thursday, April 22, 2021
Session: Session 6 (4pm-4:50pm)
Breakout Room: Room 12
Presenter: 1

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Abstract

Viral infections caused by the presence of the BK virus predispose kidney transplant patients to graft failure and immunosuppression reduction is the only effective treatment for BK infection. However, even transient reduction of immunosuppression medications can cause rejection of the transplanted kidney. Within a single large transplant center, we examined which treatment-related clinical factors are predictive of graft failure or rejection in kidney transplant patients with BK viremia. We identified a group of 400 kidney transplant recipients that had BK viral infections from 2006 to 2017. Using an electronic medical records database, I gathered data on BK treatment, including immunosuppression reduction (MMF dose reduction, MMF hold, tacrolimus dose reduction) and the use of intravenous immunoglobulin (IVIg) therapy and antiviral medications. These were compared to patient outcomes, including the presence of donor-specific antibody (DSA) and death-censored graft survival, as measured by retransplantation or return to dialysis. Regression analysis will be utilized in order to test for the presence of a statistically significant correlation to the development of DSA and a proportional hazards model to determine if treatment was related to graft failure. It is known that the presence of DSA often results in and is predictive of graft failure, however more data will need to be collected to determine if the remaining factors have a statistically significant correlation with graft failure. If we determine that any of the remaining factors are predictive of graft failure, these findings could inform future treatment for patients with viral BK infections.

Authors: Madeline Vincent, Evan Farkash, MD, PhD
Research Method: Clinical Research

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