Kidney Week

Abstract: FR-PO868

The Outcomes of Kidney Retransplantation After Graft Loss Due to BK Virus Nephropathy

Session Information

• Transplantation: Translational and Transplant Pathology
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1802 Transplantation: Clinical

Authors

• Leeaphorn, Napat, Renal Transplant Program, University of Missouri-Kansas City School of Medicine/Saint Luke's Health System, Kansas City , Missouri, United States

Napat Leeaphorn,

• Chon, Woojin James, Renal Transplant Program, University of Missouri-Kansas City School of Medicine/Saint Luke's Health System, Kansas City , Missouri, United States

Woojin James Chon,

• Cummings, Lee S., Renal Transplant Program, University of Missouri-Kansas City School of Medicine/Saint Luke's Health System, Kansas City , Missouri, United States

Lee S. Cummings,

• Cheungpasitporn, Wisit, Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States

Wisit Cheungpasitporn,

Background

Existing literature on outcomes of kidney retransplantation in patients with previous graft failure due to BK virus nephropathy (BKVN) is scarce.

Methods

Using UNOS/OPTN data, we analyzed adult patients who received their second kidney transplant between 2005 and 2015.

Results

321 out of 15,724 patients lost their first graft to BKVN (BK-group) with a median follow-up time of 4.2 years. Of these 321 patients in BK-group, 54 patients underwent preemptive second kidney transplantation. Retransplant occurred at a median of 2.2 years after graft failure. Patients in BK-group were twice more likely to receive basiliximab when compared to patients who lost their first graft due to other causes. One-year acute rejection rate in BK-group was 15%. As of March 3, 2017, 264/321 grafts were still functioning with 6 grafts that failed due to BKVN. Kaplan- Meier death-censored graft survival rates at 1, 3, and 5-year after retransplantation in BK-group were 96.9%, 95.4%, and 90.5%, respectively, which were comparable to other causes of graft loss (and perhaps superior to patients who lost their first graft due to acute rejection) [Figure 1]. Patient survival in BK-group was similar to other causes of graft loss. The log-rank test was not performed due to unbalanced sample sizes across the groups.

Conclusion

Retransplantation after graft loss due to BKVN appears to be associated with good outcomes. However, the clinical interpretation of this study is limited by the lack of information on viral clearance and transplant nephrectomy prior to retransplantation.