Kidney Week

Abstract: FR-PO904

Clinical Significance of Using the Banff 2017 Polyomavirus Nephropathy Classification in Kidney Transplantation: A Single Center Experience

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

• Maibam, Amita, University of Kentucky, Lexington, Kentucky, United States

Amita Maibam,

• Cornea, Virgilius, University of Kentucky, Lexington, Kentucky, United States

Virgilius Cornea,

• Castellanos, Ana L., University of Kentucky, Lexington, Kentucky, United States

Ana L. Castellanos,

• Mohamed, Amr El-Husseini, University of Kentucky, Lexington, Kentucky, United States

Amr El-Husseini Mohamed,

• Hassan, Waleed, University of Kentucky, Lexington, Kentucky, United States

Waleed Hassan,

• Mei, Xiaonan, University of Kentucky, Lexington, Kentucky, United States

Xiaonan Mei,

• Yaseen, Maria, University of Kentucky, Lexington, Kentucky, United States

Maria Yaseen,

• Gedaly, Roberto, University of Kentucky, Lexington, Kentucky, United States

Roberto Gedaly,

• Waid, Thomas H., University of Kentucky Medical Center, Lexington, Kentucky, United States

Thomas H. Waid,

Background

BK virus is a known cause of BK polyomavirus nephropathy (PVN) and renal allograft failure. The 2017 Banff PVN classification is based on intrarenal polyoma viral load and Banff interstitial fibrosis score. The aim of this study is to examine the clinical significance of using PVN classes and its correlation with allograft survival.

Methods

This is a single-center retrospective analysis of all patients with BK viremia (BKV) > 10,000 copies/ml from 2009 to 2017 who underwent for-cause renal allograft biopsy. Patients were histologically classified into Banff Class 1, 2 or 3. Kidney function was compared between groups. A Kaplan-Meier analysis was performed to compare renal allograft survival differences among the groups using log rank test.

Results

BKV was identified in 122 patients (88 male and 34 female). Renal allograft biopsy was performed in 61 patients (50%). Seventeen patients (27.9%) had only PVN, and another 17 patients (27.9%) had only acute cellular rejection (ACR), whereas concomitant PVN and ACR were found in 4 patients (6.6%). The remaining 23 patients (37.7%) had neither PVN nor ACR. There was no statistically significant difference in clinical, demographic and laboratory parameters between the PVN groups. Out of 17 patients with PVN, one patient had class 1 (5.8%), 9 had class 2 (52.9%) and 7 had class 3 (41.2%). The single patient with class 1 PVN was excluded from the analysis. There was a trend toward better graft survival in PVN class 2 compared to class 3 (figure 1), but it failed to reach statistical significance.

Conclusion

Allograft survival was not statistically different between PVN class 2 and 3 although a non-significant trend towards worse graft survival was seen in PVN class 3.

Survival Curves