Implementing a regional standardized BK polyomavirus screening protocol across eleven transplant centres.
BK polyomavirus
quality improvement
screening
Journal
Transplant international : official journal of the European Society for Organ Transplantation
ISSN: 1432-2277
Titre abrégé: Transpl Int
Pays: Switzerland
ID NLM: 8908516
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
revised:
18
08
2021
received:
28
06
2021
accepted:
26
09
2021
pubmed:
11
10
2021
medline:
27
1
2022
entrez:
10
10
2021
Statut:
ppublish
Résumé
BK polyomavirus (BKPyV) reactivation is regularly monitored after kidney transplant to prevent progression to BK associated nephropathy (BKAN). The New England BK Consortium, made up of 12 transplant centres in the northeastern United States, conducted a quality improvement project to examine adherence to an agreed upon protocol for BKPyV screening for kidney transplants performed in calendar years 2016-2017. In a total of 1047 kidney transplant recipients (KTR) from 11 transplant centres, 204 (19%) had BKPyV infection, defined as detection of BKPyV in plasma, with 41 (4%) KTR progressing to BKAN, defined by either evidence on biopsy tissues or as determined by treating nephrologists. BKPyV infection was treated with reduction of immune suppressants (RIS) in >70% of the patients in all but two centres. There was no graft loss because of BKAN during the two-year follow-up. There were nine cases of post-RIS acute rejection detected during this same period. Adherence to the protocol was low with 54% at 12 months and 38% at 24 months, reflecting challenges of managing transplant patients at all centres. The adherence rate was positively correlated to increased detection of BKPyV infection and was unexpectedly positively correlated to an increase in diagnosis of BKAN.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2680-2685Informations de copyright
© 2021 Steunstichting ESOT. Published by John Wiley & Sons Ltd.
Références
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Hirsch H, Randhawa P, AST Infectious Diseases Community of Practice. BK polyomavirus in solid organ transplantation: guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant 2019; 33: e13528.
Gabardi S, Pavlakis M, Tan C, et al. New England BK consortium: regional survey of BK screening and management protocols in comparison to published consensus guidelines. Transpl Infect Dis 2018; 20: e12985.
Tan CS, Gabardi S, Pavlakis M. Survey of BK virus screening practices by American Society of Transplantation members. Clin Transplant 2019; 33: e13620.