No association between delayed graft function and BK polyomavirus infection reactivation after kidney transplantation: a systematic review and meta-analysis.

INTRODUCTION

An association between delayed graft function (DGF) and BK polyomavirus (BKPyV) DNAemia is not well defined.

METHODS

We investigated this with 1) a retrospective review of a single-center cohort analysis, and 2) a systematic review & meta-analysis of published data. Kidney transplant recipients at a single-center between 01/01/2007-30/06/2018 were analyzed. Comparative analyses were done with logistic regression models based upon clinical risk factors. Following a systematic review of published studies, meta-analysis was performed using the DerSimonian-Laird random effects model.

RESULTS

In our single-center analysis, we analyzed 1,770 kidney transplant recipients with median follow up 5.3 years (interquartile range 2.7-8.7 years). BKPyVDNAemia was associated with; male sex (8.3% versus 5.3% respectively, p=0.017), ABO-incompatible transplantation (10.3% versus 4.6% respectively, p=0.004) and DGF (9.0% versus 6.3% respectively, p=0.048). In a multivariate analysis, only recipient male sex and ABO-incompatible transplantation was associated with BKPyVDNAemia. In a systematic review of published literature, we identified 11 studies and performed a meta-analysis of empirical data including our Birmingham cohort data. No significant association was observed between DGF rates and BKPyVDNAemia (OR 1.00, 95% CI 0.67-1.50).

DISCUSSION: We did not identify any association between DGF rates and subsequent BKPyVDNAemia.