Conversion to a sirolimus-based regimen is associated with lower incidence of BK viremia in low-risk kidney transplant recipients

F A Tohme; R S Kalil; C P Thomas

doi:10.1111/tid.12347

Back

Journal article

Conversion to a sirolimus-based regimen is associated with lower incidence of BK viremia in low-risk kidney transplant recipients

F A Tohme, R S Kalil and C P Thomas

Transplant infectious disease, Vol.17(1), pp.66-72

02/2015

DOI: 10.1111/tid.12347

PMID: 25582442

View Online

Abstract

BK viral nephropathy is an increasingly recognized cause of early allograft loss in kidney transplantation. This study aimed to determine whether a sirolimus (Sir)-based calcineurin inhibitor-sparing regimen is associated with a lower incidence of BK viremia. This was a single-center retrospective study. Patients were either on tacrolimus (Tac)-based or on Sir-based immunosuppression. Conversion from Tac to Sir occurred at or after 3 months if patients were <62 years of age, had calculated panel reactive antibodies of <20%, and did not have acute early rejection. Incidence of clinically significant BK viremia was 17.9% in the Tac group and 4.3% in the Sir group. Cox regression multivariate analysis showed that male gender (hazard ratio [HR] = 2.87) and switch to Sir (HR = 0.333) impacted the incidence of BK viremia. Kaplan-Meier analysis showed a higher BK-free survival in the Sir group. A trend was seen toward shorter time to resolution of BK viremia and lower peak viremia in the Sir group. Patients on Sir had a higher estimated glomerular filtration rate at each time point; 34% of patients discontinued Sir because of side effects. Conversion to Sir-based maintenance immunosuppression at or about 3 months after kidney transplantation correlates with a lower incidence of BK viremia.

Sirolimus - therapeutic use

BK Virus - drug effects

Viremia

Humans

Immunosuppressive Agents - therapeutic use

Middle Aged

Polyomavirus Infections - prevention & control

Male

Transplant Recipients

Tumor Virus Infections - drug therapy

Tumor Virus Infections - prevention & control

Incidence

Tacrolimus - therapeutic use

Immunosuppression

Adult

Female

Aged

Retrospective Studies

Polyomavirus Infections - drug therapy

Kidney Transplantation - adverse effects

Details

Title: Subtitle: Conversion to a sirolimus-based regimen is associated with lower incidence of BK viremia in low-risk kidney transplant recipients
Creators: F A Tohme - Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
R S Kalil
C P Thomas
Resource Type: Journal article
Publication Details: Transplant infectious disease, Vol.17(1), pp.66-72
DOI: 10.1111/tid.12347
PMID: 25582442
NLM abbreviation: Transpl Infect Dis
ISSN: 1398-2273
eISSN: 1399-3062
Publisher: Denmark
Language: English
Date published: 02/2015
Academic Unit: Stead Family Department of Pediatrics; Obstetrics and Gynecology; Internal Medicine
Record Identifier: 9983986081702771

Metrics

19 Record Views

22 Times Cited - Web of Science

See more details