The Prevalence and Outcomes of BK Polyoma Virus Nephropathy in Living Donor Kidney Transplant Recipients

BK polyomavirus nephropathy (BKPyVN) remains an important cause of allograft dysfunction and loss. There is little data about prevalence and outcome of BKPyVN infection from India in living donor kidney transplant recipients.

This is a retrospective analysis of all biopsy-proven BKPyVN among kidney transplant recipients at our center from January 2010 to January 2022. We compared them to age, sex, and type of immunosuppression received matched (1:2) non-BKPyVN-infected recipients transplanted during the same period.

During the study period, 2465 patients underwent kidney transplants at our center, of which 26 (1.05%) developed biopsy-proven BKPyVN. Four recipients (16%) lost their graft over a median period of 65 (IQR, 57-83) months from the time of diagnosis. The mean serum creatinine at the recent follow-up was higher in the BKPyVN arm as compared to controls (2.05 ± 1.39 vs 1.35 ± 0.46, p = 0.001.) Both BKPyVN and control arms had similar death-censored graft survival (82% vs 94%, p = 0.09) and patient survival (88% vs 96%, p = 0.184).

BKPyVN was uncommon in our kidney transplant recipients. Most patients were able to maintain their kidney function for many years, albeit at a somewhat reduced level compared with the controls, and about a fifth of our patients lost their graft.