Abstract: TH-PO0927
BK Viraemia After Kidney Transplantation and Its Association with Bladder Cancer
Session Information
- Transplantation: Clinical - Glomerular Diseases, Infections, and Rejection
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Clince, Michelle, Beaumont Hospital, Dublin, Leinster, Ireland
- O'Donoghue, Darragh, Royal College of Surgeons in Ireland, Dublin, Leinster, Ireland
- Conlon, Peter J., Beaumont Hospital, Dublin, Leinster, Ireland
- Sandys, Vicki K., University College Cork, Cork, County Cork, Ireland
- O'Kelly, Patrick, Beaumont Hospital, Dublin, Leinster, Ireland
- Cooney, Anne M., Beaumont Hospital, Dublin, Leinster, Ireland
- Brennan, Caoimhe, University College Dublin National Virus Reference Laboratory, Dublin, Leinster, Ireland
- Ní Chinnéide, Eilís M, Beaumont Hospital, Dublin, Leinster, Ireland
- Doyle, Brendan, Beaumont Hospital, Dublin, Leinster, Ireland
- Fitzpatrick, Fidelma, Beaumont Hospital, Dublin, Leinster, Ireland
- Conlon, Peter J., Beaumont Hospital, Dublin, Leinster, Ireland
Background
BK virus is an important cause of graft dysfunction and loss post kidney transplant. Treatment options are limited and predominately involve immunosuppression reduction. There have been reports of BK viraemia (BKV) and its association with bladder cancer. In this study of BKV in a large group of kidney transplant recipients (KTR) we set out to study the incidence of BKV, it’s association with kidney transplant dysfunction and impact on development of bladder cancer.
Methods
Beaumont Hospital is the national centre for adult kidney transplant in Ireland. We accessed data from the National Renal Transplant Registry (NRTR) and BK testing data from the National Virus Reference laboratory (NVRL). A cox proportional hazards model was used to assess risks associated with BKV. BK viraemia was defined as >1000 copies per mill. Histology slides were reviewed and where possible stained for BK using SV40.
Results
This study included 1372 patients who received their first kidney transplant between Jan 2011 and August 2022 with at least one BK test result available. 22.3% (305/1372) of KTR developed BKV. Those with BKV were more likely to be older at time of transplant and recieve an organ from an older donor (p=0.001). Graft survival was similar in the two groups, with 91% 5 year survival in BKV group and 88% in BK negative group.
12 KTR developed post-transplant bladder cancer (PTBC), 8 of which had BKV and 4 were BK negative. PTBC occurred in 0.87% of overall cohort. PTBC occurred in 2.6% of KTR who had BKV and in 0.37% in those who did not have BKV. In the BKV group median time from transplant to cancer diagnosis was 72 months. Four patients in BKV group have died with a median survival from diagnosis of cancer of 25.5 months (10-37). Those with BKV had a 5.9% rate of bladder cancer at 10 years compared to 0.4% rate in BK negative group. Those with BKV had a 5.31 hazard ratio for bladder cancer (p=0.008). Four patients in the BKV group had bladder histology available for review- 3/4 stained positive for SV40. Interestingly one patient in the BK negative group had histology which stained positive for SV40.
Conclusion
We provide further evidence of the oncogenic potential of BK virus in KTR and propose those with BKV undergo increased surveillance for bladder cancer.