Abstract: Background: Polyomavirus (primarily BK virus [BKV]) infection is an important cause of chronic renal dysfunction in renal transplant recipients, but its possible contribution to chronic renal dysfunction in non‐renal solid organ transplant (NRSOT) recipients has not been fully explored.
Methods: We performed a prospective, cross‐sectional study of consecutive NRSOT recipients with unexplained chronic renal dysfunction of at least a 3 months duration. Medical records were reviewed, and polymerase chain reaction was used to amplify BKV‐specific sequences from serum and urine samples. The potential associations between various demographic and transplant variables and BKV infection were assessed.
Results: Thirty‐four consecutive NRSOT recipients (23 lung, 8 liver, 2 heart, 1 heart–lung) with chronic renal dysfunction were enrolled at a median of 3.5 years (range 0.3–12.5 years) post transplantation. Five of the 34 (15%) patients had BKV viruria (range 1040–1.8 × 106 copies/mL), but none had BKV viremia. BK viruria was associated with mycophenolate mofetil use (5 of 19 [26%] vs. 0 of 15, P=0.03) and a history of cytomegalovirus disease (3 of 4 [75%] vs. 2 of 30 [7%], P<0.01). However, the mean estimated creatinine clearance was similar in patients with or without BKV viruria (49 vs. 47 mL/min).
Conclusions: BKV viruria was present in a proportion of NRSOT patients with otherwise unexplained chronic renal dysfunction. The possibility that BKV infection might contribute to chronic renal dysfunction in this setting warrants further investigation.
