Korean J Pediatr.  2019 Nov;62(11):422-427. 10.3345/kjp.2019.00388.

Clinical manifestations of BK virus infection in pediatric kidney transplant patients

• Kwon Y
• Kim JY
• Lee Y
• Cho H

• KMID: 2465645
• DOI: http://doi.org/10.3345/kjp.2019.00388

Abstract

BACKGROUND
Polyomavirus BK (BKV) infection is an important cause of graft loss in kidney transplant patients. PURPOSE: The purpose of this study was to evaluate clinical findings and risk factors for BKV in pediatric patients after kidney transplantation.
METHODS
This retrospective single-center study included 31 pediatric kidney transplant recipients from January 2002 to December 2017. Two patients received 2 transplantations during the study period, and each transplant was analyzed independently. Total number of cases is 33 cases with 31 patients. BKV infection was confirmed from blood samples via periodic quantitative polymerase chain reaction.
RESULTS
The mean age at kidney transplantation was 11.0±4.7 years, and the male-to-female ratio was 2.7:1. Three patients had a past medical history of high-dose chemotherapy and autologous stem-cell transplantation for solid tumors. Nine patients (27.3%) developed BKV infection. The median period from kidney transplantation to BKV detection in blood was 5.6 months. There was no statistically significant difference in estimated glomerular filtration rate between patients with and those without BKV infection. Among 9 patients with BKV viremia, 7 were treated by reducing their immunosuppressant dose, and BKV was cleared in 6 of these 7 patients. In the other 2 BKV-positive patients, viremia improved without immunosuppressant reduction.
CONCLUSION
BKV infection is common in children with kidney transplantation and might not have affected short-term renal function in our patient sample due to early immunosuppressant reduction at the time of BKV detection.

Keyword

BK virus; Kidney transplant; Child

MeSH Terms

BK Virus*
Child
Drug Therapy
Glomerular Filtration Rate
Humans
Kidney Transplantation
Kidney*
Polymerase Chain Reaction
Polyomavirus
Retrospective Studies
Risk Factors
Transplant Recipients
Transplants
Viremia