Kidney Week

Abstract: SA-OR010

BK Virus Nephropathy: Characterization of an Interferon Signature and Identification of Risk Factors for Graft Failure

Session Information

• Access, Organ Utilization, and Infectious Disease
  October 27, 2018 | Location: 24A, San Diego Convention Center
  Abstract Time: 06:18 PM - 06:30 PM

Category: Transplantation

• 1802 Transplantation: Clinical

Authors

• Dadhania, Darshana, Weill Cornell Medical College, New York, New York, United States

Darshana Dadhania, MD, MS

• Srisung, Weeraporn, NYP-Weill Cornell Medical Center, New York, New York, United States

Weeraporn Srisung,

• Abuhelaiqa, Essa, NYP-Weill Cornell Medical Center, New York, New York, United States

Essa Abuhelaiqa,

• Snopkowski, Catherine, Weill Medical College of Cornell University, New York, New York, United States

Catherine Snopkowski,

• Li, Carol Y., Weill Cornell Medical College, New York, New York, United States

Carol Y. Li,

• Lee, John Richard, Weill Cornell Medicine-, New York, New York, United States

John Richard Lee,

• Muthukumar, Thangamani, Weill Cornell Medical Center, New York, New York, United States

Thangamani Muthukumar,

• Ding, Ruchuang, weill Cornell Medical College, Beechhurst, New York, United States

Ruchuang Ding,

• Seshan, Surya V., Weill Cornell Medical Center, New York, New York, United States

Surya V. Seshan,

• Suthanthiran, Manikkam, Weill Cornell Medical College, New York, New York, United States

Manikkam Suthanthiran,

Background

BK virus nephropathy(BKVN) is an important cause of allograft failure. Identification of its immune pathways may help design better therapeutics.

Methods

We measured urinary cell mRNAs in 53 BKVN patients and 43 patients with normal protocol biopsies. Among the 53 BKVN cases, 18 grafts failed within 3 years post diagnosis and none in the normal group. Levels of mRNA were measured using kinetic, quantitative polymerase-chain assays. We compared mRNA levels of 53 BKVN vs. 43 normal patients, and within BKVN group, the 18 BKVN with graft loss vs. 35 BKVN without graft loss.

Results

Among the transcripts quantified in a total of 96 renal graft recipients, urinary cell levels of 18S rRNA, IP-10 and MIG were significantly higher in the BKVN group vs. normal group (all P<0.0001)(Table 1). Of the 53 BKVN cases, 18 lost their grafts and they were more likely to have received a deceased-donor renal transplant(DDRT) (P=0.03) and a higher creatinine(SCr) at time of BKVN diagnosis (2.88+/-1.18 mg/dl vs. 1.96+/-0.69 mg/dl;P=0.005). Urinary cell levels of PAI-1 mRNA predicted graft failure(Figure 1). Multivariate analysis demonstrated that PAI-1 mRNA level (OR: 2.6;P= 0.005), biopsy SCr (OR: 9.1;P<0.001) and DDRT (OR: 8.3;P=0.01) were independent predictors of graft failure.

Conclusion

BKVN is associated with an inflammatory milieu characterized by an interferon signature. Urinary cell levels of the acute phase reactant PAI-1 offer a noninvasive means to predict graft failure after BKVN diagnosis.

Table 1.

Figure 1.