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Updated: Jan 14, 2026
Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
Outcomes of BK in simultaneous heart kidney transplant: A 3 center experience
Alex Nica1, Suman Misra2, D Eric Steidley3
1Mayo Alix School of Medicine, Mayo Clinic, Phoenix, AZ.
Insights
BK polyomavirus DNAemia is common after heart-kidney transplants, increasing kidney rejection risk. However, it does not impact patient survival or overall allograft function.
Area of Science:
- Nephrology
- Transplant Surgery
- Virology
Background:
- BK polyomavirus DNAemia is prevalent in kidney transplant recipients.
- Data on BK polyomavirus DNAemia in simultaneous heart-kidney transplant recipients is limited.
- Understanding BK polyomavirus DNAemia is crucial for managing transplant outcomes.
Purpose of the Study:
- To assess the prevalence of BK polyomavirus DNAemia in simultaneous heart-kidney transplant recipients.
- To determine the incidence of BK polyomavirus DNAemia-associated nephropathy.
- To evaluate the impact of BK polyomavirus DNAemia on allograft function and patient survival.
Main Methods:
- Retrospective study from January 2005 to June 2022.
- Analysis of BK polyomavirus DNAemia and nephropathy rates in heart-kidney transplant recipients.
- Comparison of outcomes between BK polyomavirus DNAemia positive and negative groups.
Main Results:
- 38% of recipients developed BK polyomavirus DNAemia; 47% of those developed nephropathy.
- BK polyomavirus DNAemia was associated with significantly higher kidney rejection rates (47% vs. 25%).
- No significant differences in patient survival or allograft function were observed.
Conclusions:
- BK polyomavirus DNAemia and associated nephropathy are common in heart-kidney transplants.
- BK polyomavirus DNAemia increases kidney rejection risk but does not affect patient survival.
- Management strategies may need to consider the impact on kidney allografts.
Background:
BK polyomavirus DNAemia is common in solitary kidney transplants (KTs), with the risk of developing BK DNAemia-associated nephropathy, but data is limited in simultaneous heart-KTs. Our aim was to assess the prevalence and outcomes of BK DNAemia after simultaneous heart-KT.
Methods:
Retrospective study between January 1, 2005, and June 30, 2022, analyzing the prevalence of BK DNAemia and BK DNAemia-associated nephropathy rates in simultaneous heart-KT recipients between BK DNAemia positive and BK DNAemia negative groups. Secondary outcomes included heart and kidney allograft function, kidney allograft survival, rejection rates, and patient survival.
Results:
Thirty-eight percent developed BK DNAemia, while 47% of patients with BK DNAemia developed BK DNAemia-associated nephropathy. The median time to first detection of BK DNAemia was 86 days (IQR: 50-118 days) and resolution was 216 days (IQR: 106-366 days). The BK DNAemia positive group had significantly higher kidney rejection rates (47% vs 25%; p = 0.01). There was no significant difference in patient survival (p = 0.7) or allograft function of either allograft between the two groups. Immunosuppression was reduced more frequently in the BK DNAemia positive group (84% vs 46%; p < 0.001). There was an increased risk of subsequent kidney rejection in patients who developed BK DNAemia (p = 0.024).
Conclusion:
BK DNAemia and BK DNAemia-associated nephropathy are common in simultaneous heart-kidney recipients, leading to increased kidney rejection rates without affecting overall patient survival or allograft kidney and heart function.
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