Onset and progression of de novo donor-specific anti-human leukocyte antigen antibodies after BK polyomavirus and preemptive immunosuppression reduction
Background BK polyomavirus (BKPyV) viremia/nephropathy and reduction in immunosuppression following viremia may increase the risk of alloimmune activation and allograft rejection. This study investigates the impact of BKPyV viremia on de novo donor anti‐human leukocyte antigen (HLA)‐specific antibod...
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| Veröffentlicht in: | Transplant infectious disease 2015-12, Vol.17 (6), p.848-858 |
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| creator | Dieplinger, G. Everly, M.J. Briley, K.P. Haisch, C.E. Bolin, P. Maldonado, A.Q. Kendrick, W.T. Kendrick, S.A. Morgan, C. Terasaki, P.I. Rebellato, L.M. |
| description | Background
BK polyomavirus (BKPyV) viremia/nephropathy and reduction in immunosuppression following viremia may increase the risk of alloimmune activation and allograft rejection. This study investigates the impact of BKPyV viremia on de novo donor anti‐human leukocyte antigen (HLA)‐specific antibodies (dnDSA).
Patients and methods
All primary renal transplants at East Carolina University from March 1999 to December 2010, with at least 1 post‐transplant BKPyV viral load testing, were analyzed. Patients were negative for anti‐HLA antibodies to donor antigens (tested via single antigen beads) at transplantation and at first BKPyV testing.
Results
Nineteen of 174 patients (11%) tested positive for BKPyV viremia. Within 24 months of BKPyV viremia detection, 79% of BKPyV‐viremic patients developed dnDSA. Only 20% of BKPyV viremia‐persistent cases, compared to 86% of BKPyV viremia‐resolved cases, developed dnDSA (P = 0.03). Poor allograft survival was evident in BKPyV viremia‐persistent patients (60% failure by 2 years post BKPyV diagnosis) and in BKPyV viremia‐resolved patients with dnDSA (5‐year post BKPyV diagnosis allograft survival of 48%).
Conclusions
Post‐transplant BKPyV viremia and preemptive immunosuppression reduction is associated with high rates of dnDSA. When preemptively treating BKPyV viremia, dnDSA should be monitored to prevent allograft consequences. |
| doi_str_mv | 10.1111/tid.12467 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1760859222</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3924243981</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3917-a9630fb8808a5b79abeeb021ddfbf516837f6787d2a1d8fbb4698b6055db7acf3</originalsourceid><addsrcrecordid>eNp1kc1u1TAQhSMEoqWw4AWQJTawSGs7iZ0saYG2cEWFVGBp2fG4uE3s1I4v3Dfp49a9P10g4c0cjb85Y-sUxWuCD0k-R7PVh4TWjD8p9knVdWWFGX261m1JKa_2ihcxXmNMeFd3z4s9yuqaMsz3i7sLF2FG0mk0BX8VIEbrHfIGaUDOLz3S3vlQxgl6a2yfydmWv9MoHRog3fh-NcO6eQVuXZXXFiKSZoaAjr-iyQ8rP8qlDSlu9wCM02yXgOw4Judjmqbd4gA69XNWL4tnRg4RXm3rQfHj86fLk7NycXF6fvJhUfZVR3gpO1Zho9oWt7JRvJMKQGFKtDbKNIS1FTeMt1xTSXRrlKpZ1yqGm0YrLntTHRTvNr75-7cJ4ixGG3sYBunApygIZ7htOkppRt_-g177FFx-XaYaznHdUpKp9xuqDz7GAEZMwY4yrATB4iEukeMS67gy-2brmNQI-pHc5ZOBow3wxw6w-r-TuDz_uLMsNxM2zvD3cUKGG5FveSN-fTsVP6sF_n78hWdxD2Ywsi4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1757704821</pqid></control><display><type>article</type><title>Onset and progression of de novo donor-specific anti-human leukocyte antigen antibodies after BK polyomavirus and preemptive immunosuppression reduction</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Dieplinger, G. ; Everly, M.J. ; Briley, K.P. ; Haisch, C.E. ; Bolin, P. ; Maldonado, A.Q. ; Kendrick, W.T. ; Kendrick, S.A. ; Morgan, C. ; Terasaki, P.I. ; Rebellato, L.M.</creator><creatorcontrib>Dieplinger, G. ; Everly, M.J. ; Briley, K.P. ; Haisch, C.E. ; Bolin, P. ; Maldonado, A.Q. ; Kendrick, W.T. ; Kendrick, S.A. ; Morgan, C. ; Terasaki, P.I. ; Rebellato, L.M.</creatorcontrib><description>Background
BK polyomavirus (BKPyV) viremia/nephropathy and reduction in immunosuppression following viremia may increase the risk of alloimmune activation and allograft rejection. This study investigates the impact of BKPyV viremia on de novo donor anti‐human leukocyte antigen (HLA)‐specific antibodies (dnDSA).
Patients and methods
All primary renal transplants at East Carolina University from March 1999 to December 2010, with at least 1 post‐transplant BKPyV viral load testing, were analyzed. Patients were negative for anti‐HLA antibodies to donor antigens (tested via single antigen beads) at transplantation and at first BKPyV testing.
Results
Nineteen of 174 patients (11%) tested positive for BKPyV viremia. Within 24 months of BKPyV viremia detection, 79% of BKPyV‐viremic patients developed dnDSA. Only 20% of BKPyV viremia‐persistent cases, compared to 86% of BKPyV viremia‐resolved cases, developed dnDSA (P = 0.03). Poor allograft survival was evident in BKPyV viremia‐persistent patients (60% failure by 2 years post BKPyV diagnosis) and in BKPyV viremia‐resolved patients with dnDSA (5‐year post BKPyV diagnosis allograft survival of 48%).
Conclusions
Post‐transplant BKPyV viremia and preemptive immunosuppression reduction is associated with high rates of dnDSA. When preemptively treating BKPyV viremia, dnDSA should be monitored to prevent allograft consequences.</description><identifier>ISSN: 1398-2273</identifier><identifier>EISSN: 1399-3062</identifier><identifier>DOI: 10.1111/tid.12467</identifier><identifier>PMID: 26442607</identifier><language>eng</language><publisher>Denmark: Blackwell Publishing Ltd</publisher><subject>Adult ; anti-human leukocyte antigen antibody ; Antibodies - blood ; BK Virus - isolation & purification ; Dose-Response Relationship, Drug ; Female ; HLA Antigens - immunology ; Humans ; immunosuppression ; Immunosuppression - adverse effects ; Immunosuppressive Agents - administration & dosage ; Immunosuppressive Agents - therapeutic use ; Kidney Transplantation - adverse effects ; Male ; Middle Aged ; polyomavirus ; Polyomavirus Infections - blood ; Polyomavirus Infections - immunology ; transplantation ; Tumor Virus Infections - blood ; Tumor Virus Infections - immunology ; Viremia</subject><ispartof>Transplant infectious disease, 2015-12, Vol.17 (6), p.848-858</ispartof><rights>2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><rights>2015 Wiley Periodicals, Inc</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3917-a9630fb8808a5b79abeeb021ddfbf516837f6787d2a1d8fbb4698b6055db7acf3</citedby><cites>FETCH-LOGICAL-c3917-a9630fb8808a5b79abeeb021ddfbf516837f6787d2a1d8fbb4698b6055db7acf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Ftid.12467$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Ftid.12467$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26442607$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dieplinger, G.</creatorcontrib><creatorcontrib>Everly, M.J.</creatorcontrib><creatorcontrib>Briley, K.P.</creatorcontrib><creatorcontrib>Haisch, C.E.</creatorcontrib><creatorcontrib>Bolin, P.</creatorcontrib><creatorcontrib>Maldonado, A.Q.</creatorcontrib><creatorcontrib>Kendrick, W.T.</creatorcontrib><creatorcontrib>Kendrick, S.A.</creatorcontrib><creatorcontrib>Morgan, C.</creatorcontrib><creatorcontrib>Terasaki, P.I.</creatorcontrib><creatorcontrib>Rebellato, L.M.</creatorcontrib><title>Onset and progression of de novo donor-specific anti-human leukocyte antigen antibodies after BK polyomavirus and preemptive immunosuppression reduction</title><title>Transplant infectious disease</title><addtitle>Transpl Infect Dis</addtitle><description>Background
BK polyomavirus (BKPyV) viremia/nephropathy and reduction in immunosuppression following viremia may increase the risk of alloimmune activation and allograft rejection. This study investigates the impact of BKPyV viremia on de novo donor anti‐human leukocyte antigen (HLA)‐specific antibodies (dnDSA).
Patients and methods
All primary renal transplants at East Carolina University from March 1999 to December 2010, with at least 1 post‐transplant BKPyV viral load testing, were analyzed. Patients were negative for anti‐HLA antibodies to donor antigens (tested via single antigen beads) at transplantation and at first BKPyV testing.
Results
Nineteen of 174 patients (11%) tested positive for BKPyV viremia. Within 24 months of BKPyV viremia detection, 79% of BKPyV‐viremic patients developed dnDSA. Only 20% of BKPyV viremia‐persistent cases, compared to 86% of BKPyV viremia‐resolved cases, developed dnDSA (P = 0.03). Poor allograft survival was evident in BKPyV viremia‐persistent patients (60% failure by 2 years post BKPyV diagnosis) and in BKPyV viremia‐resolved patients with dnDSA (5‐year post BKPyV diagnosis allograft survival of 48%).
Conclusions
Post‐transplant BKPyV viremia and preemptive immunosuppression reduction is associated with high rates of dnDSA. When preemptively treating BKPyV viremia, dnDSA should be monitored to prevent allograft consequences.</description><subject>Adult</subject><subject>anti-human leukocyte antigen antibody</subject><subject>Antibodies - blood</subject><subject>BK Virus - isolation & purification</subject><subject>Dose-Response Relationship, Drug</subject><subject>Female</subject><subject>HLA Antigens - immunology</subject><subject>Humans</subject><subject>immunosuppression</subject><subject>Immunosuppression - adverse effects</subject><subject>Immunosuppressive Agents - administration & dosage</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Male</subject><subject>Middle Aged</subject><subject>polyomavirus</subject><subject>Polyomavirus Infections - blood</subject><subject>Polyomavirus Infections - immunology</subject><subject>transplantation</subject><subject>Tumor Virus Infections - blood</subject><subject>Tumor Virus Infections - immunology</subject><subject>Viremia</subject><issn>1398-2273</issn><issn>1399-3062</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1u1TAQhSMEoqWw4AWQJTawSGs7iZ0saYG2cEWFVGBp2fG4uE3s1I4v3Dfp49a9P10g4c0cjb85Y-sUxWuCD0k-R7PVh4TWjD8p9knVdWWFGX261m1JKa_2ihcxXmNMeFd3z4s9yuqaMsz3i7sLF2FG0mk0BX8VIEbrHfIGaUDOLz3S3vlQxgl6a2yfydmWv9MoHRog3fh-NcO6eQVuXZXXFiKSZoaAjr-iyQ8rP8qlDSlu9wCM02yXgOw4Judjmqbd4gA69XNWL4tnRg4RXm3rQfHj86fLk7NycXF6fvJhUfZVR3gpO1Zho9oWt7JRvJMKQGFKtDbKNIS1FTeMt1xTSXRrlKpZ1yqGm0YrLntTHRTvNr75-7cJ4ixGG3sYBunApygIZ7htOkppRt_-g177FFx-XaYaznHdUpKp9xuqDz7GAEZMwY4yrATB4iEukeMS67gy-2brmNQI-pHc5ZOBow3wxw6w-r-TuDz_uLMsNxM2zvD3cUKGG5FveSN-fTsVP6sF_n78hWdxD2Ywsi4</recordid><startdate>201512</startdate><enddate>201512</enddate><creator>Dieplinger, G.</creator><creator>Everly, M.J.</creator><creator>Briley, K.P.</creator><creator>Haisch, C.E.</creator><creator>Bolin, P.</creator><creator>Maldonado, A.Q.</creator><creator>Kendrick, W.T.</creator><creator>Kendrick, S.A.</creator><creator>Morgan, C.</creator><creator>Terasaki, P.I.</creator><creator>Rebellato, L.M.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201512</creationdate><title>Onset and progression of de novo donor-specific anti-human leukocyte antigen antibodies after BK polyomavirus and preemptive immunosuppression reduction</title><author>Dieplinger, G. ; Everly, M.J. ; Briley, K.P. ; Haisch, C.E. ; Bolin, P. ; Maldonado, A.Q. ; Kendrick, W.T. ; Kendrick, S.A. ; Morgan, C. ; Terasaki, P.I. ; Rebellato, L.M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3917-a9630fb8808a5b79abeeb021ddfbf516837f6787d2a1d8fbb4698b6055db7acf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>anti-human leukocyte antigen antibody</topic><topic>Antibodies - blood</topic><topic>BK Virus - isolation & purification</topic><topic>Dose-Response Relationship, Drug</topic><topic>Female</topic><topic>HLA Antigens - immunology</topic><topic>Humans</topic><topic>immunosuppression</topic><topic>Immunosuppression - adverse effects</topic><topic>Immunosuppressive Agents - administration & dosage</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Male</topic><topic>Middle Aged</topic><topic>polyomavirus</topic><topic>Polyomavirus Infections - blood</topic><topic>Polyomavirus Infections - immunology</topic><topic>transplantation</topic><topic>Tumor Virus Infections - blood</topic><topic>Tumor Virus Infections - immunology</topic><topic>Viremia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dieplinger, G.</creatorcontrib><creatorcontrib>Everly, M.J.</creatorcontrib><creatorcontrib>Briley, K.P.</creatorcontrib><creatorcontrib>Haisch, C.E.</creatorcontrib><creatorcontrib>Bolin, P.</creatorcontrib><creatorcontrib>Maldonado, A.Q.</creatorcontrib><creatorcontrib>Kendrick, W.T.</creatorcontrib><creatorcontrib>Kendrick, S.A.</creatorcontrib><creatorcontrib>Morgan, C.</creatorcontrib><creatorcontrib>Terasaki, P.I.</creatorcontrib><creatorcontrib>Rebellato, L.M.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transplant infectious disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dieplinger, G.</au><au>Everly, M.J.</au><au>Briley, K.P.</au><au>Haisch, C.E.</au><au>Bolin, P.</au><au>Maldonado, A.Q.</au><au>Kendrick, W.T.</au><au>Kendrick, S.A.</au><au>Morgan, C.</au><au>Terasaki, P.I.</au><au>Rebellato, L.M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Onset and progression of de novo donor-specific anti-human leukocyte antigen antibodies after BK polyomavirus and preemptive immunosuppression reduction</atitle><jtitle>Transplant infectious disease</jtitle><addtitle>Transpl Infect Dis</addtitle><date>2015-12</date><risdate>2015</risdate><volume>17</volume><issue>6</issue><spage>848</spage><epage>858</epage><pages>848-858</pages><issn>1398-2273</issn><eissn>1399-3062</eissn><abstract>Background
BK polyomavirus (BKPyV) viremia/nephropathy and reduction in immunosuppression following viremia may increase the risk of alloimmune activation and allograft rejection. This study investigates the impact of BKPyV viremia on de novo donor anti‐human leukocyte antigen (HLA)‐specific antibodies (dnDSA).
Patients and methods
All primary renal transplants at East Carolina University from March 1999 to December 2010, with at least 1 post‐transplant BKPyV viral load testing, were analyzed. Patients were negative for anti‐HLA antibodies to donor antigens (tested via single antigen beads) at transplantation and at first BKPyV testing.
Results
Nineteen of 174 patients (11%) tested positive for BKPyV viremia. Within 24 months of BKPyV viremia detection, 79% of BKPyV‐viremic patients developed dnDSA. Only 20% of BKPyV viremia‐persistent cases, compared to 86% of BKPyV viremia‐resolved cases, developed dnDSA (P = 0.03). Poor allograft survival was evident in BKPyV viremia‐persistent patients (60% failure by 2 years post BKPyV diagnosis) and in BKPyV viremia‐resolved patients with dnDSA (5‐year post BKPyV diagnosis allograft survival of 48%).
Conclusions
Post‐transplant BKPyV viremia and preemptive immunosuppression reduction is associated with high rates of dnDSA. When preemptively treating BKPyV viremia, dnDSA should be monitored to prevent allograft consequences.</abstract><cop>Denmark</cop><pub>Blackwell Publishing Ltd</pub><pmid>26442607</pmid><doi>10.1111/tid.12467</doi><tpages>11</tpages></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult anti-human leukocyte antigen antibody Antibodies - blood BK Virus - isolation & purification Dose-Response Relationship, Drug Female HLA Antigens - immunology Humans immunosuppression Immunosuppression - adverse effects Immunosuppressive Agents - administration & dosage Immunosuppressive Agents - therapeutic use Kidney Transplantation - adverse effects Male Middle Aged polyomavirus Polyomavirus Infections - blood Polyomavirus Infections - immunology transplantation Tumor Virus Infections - blood Tumor Virus Infections - immunology Viremia |
| title | Onset and progression of de novo donor-specific anti-human leukocyte antigen antibodies after BK polyomavirus and preemptive immunosuppression reduction |
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