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- W2045559024 abstract "P821 Aims: To determine the effects of acute rejection on viral load monitoring parameters in renal transplant recipients diagnosed with polyomavirus nephropathy (PVN). Methods: Serum creatinine, incidence of graft loss, biopsy findings and BKV serum and urine viral loads were analyzed in 11 PVN patients by Taqman PCR. Anti-BKV antibody titers were analyzed by hemagglutination assay. Median length of follow-up was 29 (8-126) weeks post PVN. Statistics: 2-sample median tests and z tests for comparing proportions were performed. A p value of < 0.05 was considered to be significant. All patients underwent immunosuppression reduction as treatment for PVN. Results: Pre PVN diagnosis, 4 (36%) patients had 7 acute rejection episodes. At the time of PVN diagnosis 2 (18%) patients had mild acute rejection. Post PVN, 4 (36%) patients had 6 acute rejection episodes, with 67% being mild. Median time to acute rejection post PVN was 18 (2-60) weeks. Four patients (67%) who experienced pre PVN rejection also experienced rejection post PVN. Rejection episode treatments consisted of: none in 1, increased tacrolimus in 2, IVIG in 1, IVIG and increased tacrolimus in 1, and leflunomide in 1. Median viral loads in patients with post PVN acute rejection vs no rejection were not different in serum (2.01 x 10 4 vs 9.00 x 10 4 BKV copies/ml, p = 0.22) or in the urine (5.37 x 10 5 copies/mL vs 8.93 x 10 6 BKV copies/mL, p = 0.28). Interestingly, median anti-BKV antibody titers were lower in patients with post PVN rejection than in patients with none (16384 vs 32768 HA units, p = 0.02) and not surprisingly, median serum creatinine values were significantly higher in patients who had experienced rejection post PVN than those who did not (2.7 vs 1.9 mg/dL, p = 0.0003). Graft losses occurred in one patient who never experienced post PVN rejection (chronic allograft nephropathy) and in one patient who experienced multiple acute rejection episodes followed by humoral rejection and worsening PVN. Conclusions: 1) Patients who experience rejection prior to PVN are at high risk of developing rejection after immunosuppression reduction and PVN. 2) Patients who experience rejection post PVN have worse renal function than those who did not experience any rejection post PVN. 3) Low graft loss rates may be achieved in patients with PVN, despite a higher frequency of acute rejection in some patients." @default.
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- W2045559024 date "2004-07-01" @default.
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- W2045559024 title "OUTCOMES OF PATIENTS WITH REJECTION POST POLYOMAVIRUS NEPHROPATHY" @default.
- W2045559024 doi "https://doi.org/10.1097/00007890-200407271-01317" @default.
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