ABSTRACT
Objective:To retrospectively analyze the BKV infection of recipients after kidney transplantation(RT)and provide references for diagnosing and treating BK virus infection post-RT.Methods:From January 1, 2018 to December 31, 2020, clinical and follow-up data were reviewed for 561 RT recipients(cadaveric and living donor kidney)at First Hospital of Jilin University. DNA loading of BK virus in blood and urine was determined by quantitative polymerase chain reaction(qPCR)and kidney allograft biopsy performed. Based upon the results, they are divided into four groups of A (372 cases), high-level BK viruria(group B, 128 cases), BK viremia(group C, 52 cases)and BK virus nephropathy(BKVN)(group D, 9 cases). The variables related to BK virus infection were screened by univariate analysis. Meaningful variables( P<0.1)are incorporated into the multi-factor ordered Logistic regression model for examining the independent risk factors of postoperative BK virus infection. Results:The incidence of high-level BKV viruria is 33.69%(189/561)at 18 months post-RT. The average detection time is(4.2±3.8)months, the incidence of BK viremia 10.87%(61/561)and the average detection time(5.2±3.6)months post-RT. The incidence of BKVN is 1.78%(9/561)and the average detection time(7.0±4.0)months post-RT. Univariate analysis showed that gender, age, immunotherapeutic regimen, history of acute rejection and type of donor are correlated with BKV infection. Multivariate Logistic regression analysis indicated that male recipient( P=0.013), immune maintenance regimen( P<0.001)and history of acute rejection( P=0.002)were independent risk factors for developing postoperative BKV infection. Conclusions:There is a high incidence of BKV infection within 12 months post-RT. Male recipient, history of acute rejection and immune maintenance regimen are independent risk factors for BKV infection post-RT.
ABSTRACT
Objective:To compare the medium/long-term prognosis of kidney transplant recipients with expanded criteria donor(ECD)versus standard criteria donor(SCD).Methods:From August 2011 to May 2017, a total of 506 cases underwent renal transplantation.Based upon baseline clinical data, they were divided into two groups of ECD(67 cases)and SCD(230 cases). And 1: 4 propensity score matching was employed for maximizing the elimination of selection bias influence on the results by rank-sum test.Results:There was no statistical difference existed between ECD and SCD donor kidney in acute rejection, delayed graft function and all-cause infection(all P>0.05). The value of eGFR of ECD donor kidney recipients was slightly lower than that of SCD group at Week 1 and Year 4 postoperatively( P<0.05). And there was no inter-group statistical significance in the fifth year( P=0.273). No significant inter-group difference existed in human/renal survival rate( P=0.143, P=0.076). Conclusions:Appropriate selection criteria and recipient selection criteria can make the application of ECD donor kidney safer and more scientific so as to benefit more patients.