Abstract: PO2452
Early Increase in Urinary Exosomal BK Virus MicroRNA as a Predictive Marker of BK Virus Nephropathy: A Prospective Kidney Transplantation Cohort
Session Information
- Transplant Complications: Infection
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Cho, Won-Hee, Kyung Hee University Hospital at Gangdong Department of Orthopedic Surgery, Seoul, Korea (the Republic of)
- Jung, Su Woong, Kyung Hee University Hospital at Gangdong Department of Orthopedic Surgery, Seoul, Korea (the Republic of)
- Moon, Ju young, Kyung Hee University Hospital at Gangdong Department of Orthopedic Surgery, Seoul, Korea (the Republic of)
- Kim, Yang gyun, Kyung Hee University Hospital at Gangdong, Seoul, Korea (the Republic of)
- Jeong, Kyung hwan, Kyung Hee University Hospital at Gangdong, Seoul, Korea (the Republic of)
- Lee, Sangho, Kyung Hee University Hospital at Gangdong, Seoul, Korea (the Republic of)
Background
Urinary exosomal bkv-miR-B1-5p was associated with BK virus (BKV) nephropathy (BKVN) in a cross-sectional study. However, its time-dependent post-transplantation changes and predictive value for BKVN have not been investigated.
Methods
We carried out a multicenter prospective cohort from which 83 kidney transplant recipients (KRTs) in South Korea (biopsy-proven BKVN [n=10], presumptive BKVN [n=12], and non-BKVN patients [n=61]) were selected for the measurement of urinary exosomal bkv-miR-B1-5p levels at 0.5, 3, 6, and 12 months posttransplant.
Results
At 2 weeks posttransplant, urinary exosomal bkv-miR-B1-5p levels showed an increasing trend (non-BKVN < presumptive BKVN < biopsy-proven BKVN), while plasma BKV DNA levels were undetectable in all groups. Thereafter, both urinary exosomal bkv-miR-B1-5p and plasma BKV DNA levels peaked at 3 months posttransplant and then decreased. Multivariable-adjusted Cox regression showed that urinary exosomal bkv-miR-B1-5p levels at 2 weeks and 3 months posttransplant independently predicted biopsy-proven BKVN development. In particular, the early increase in urinary exosomal bkv-miR-B1-5p makes its predictive ability for biopsy-proven BKVN superior to that of plasma BKV DNA at 2 weeks posttransplant.
Conclusion
Our results suggest that urinary exosomal bkv-miR-B1-5p can be used to identify the KRTs at high risk for BKVN at earlier time than plasma BKV DNA loads, enabling earlier intervention.