AUTHOR=Saláková Martina , Ludvíková Viera , Hamšíková Eva , Kolářová Marie , Šroller Vojtěch , Viklický Ondřej , Wohlfahrtová Mariana 

TITLE=Pretransplantation seroreactivity in kidney donors and recipients as a predictive factor for posttransplant BKPyV-DNAemia

JOURNAL=Frontiers in Immunology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.929946

DOI=10.3389/fimmu.2022.929946

ISSN=1664-3224

ABSTRACT=BK polyomavirus (BKPyV) often reactivates after kidney transplantation, causing BKPyV-associated nephropathy (BKPyVAN) in 1–10% cases with potential detrimental effect on allograft survival. Kidney recipients are regularly screened to detect BKPyV DNA in blood and urine after renal transplantation. However, this strategy may not always reduce the risk of developing BKPyVAN and other predictive markers are needed. To evaluate the role of pretransplant BKPyV specific antibody, 210 kidney transplant recipients and 130 donors were screened for the presence of BKPyV DNA and BKPyV specific antibody. We found that donor BKPyV IgG seroprevalence and antibody level was strongly associated with BKPyV viremia and BKPyVAN; however, multivariant analysis found the presence of anti-BKPyV specific antibodies as a predictive factor only for BKPyV viremia. The pretransplant status of the recipients had no effect on posttransplant BKPyV viremia and BKVAN. BKPyV IgG levels in recipients without BKPyV infection remained stable during one-year follow-up, while a considerable increase was observed in viremic and viruric recipients. The determination of specific BKPyV antibodies in kidney allograft donors represent a good and reliable predictive marker for posttransplant BKPyV replication and risk stratification in transplant recipients.