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No clinical benefit of rapid versus gradual tapering of immunosuppression to treat sustained BK virus viremia after kidney transplantation: a single-center experience

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Devresse, Arnaud [UCL] Tinel, Claire Vermorel, Agathe Snanoudj, Renaud Morin, Lise Anglicheau, Dany

(eng) Immunosuppressive drug tapering is currently the recommended treatment of BK virus (BKV) viremia after kidney transplantation; however, its exact modalities remain unclear. We retrospectively compared two consecutive strategies in 111 patients with sustained viremia: a gradual monitoring/tapering group (GT, n = 57) before 2012 and a rapid monitoring/tapering group (RT, n = 54) after 2012. At viremia diagnosis, the dose of mycophenolic acid (MPA) and tacrolimus levels (T0 ) were similar among patient groups. However, following onset, the dose of MPA at 1 month (P = 0.002) and 3 months (P = 0.005) and Tac T0 at 1 month (P = 0.030) and 3 months (P = 0.006) were lower in the RT group. This rapid minimization shortened BKV viremia (P < 0.001) and resulted in a better protection of graft function in patients with confirmed BKV-associated nephropathy (P = 0.033) without impacting 5-year graft survival. Survival without rejection was similar (P = 0.571), but the RT group had increased the development of de novo donor-specific antibodies (dnDSAs; P < 0.001). Multivariate Cox analysis identified basiliximab versus Thymoglobulin® induction [hazard ratio (HR), 3.090; P = 0.001] and the RT strategy (HR, 6.021; P = 0.002) as independently associated with dnDSAs. Compared to a gradual tapering, rapid immunosuppression tapering to treat sustained BKV viremia does not improve medium-term clinical outcome but increases the risk of developing dnDSAs.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès libre
Publication date 2019
Language Anglais
Journal information "Transplant International" - Vol. 32, no. 5, p. 481-492 (2019)
Peer reviewed yes
Publisher Blackwell Pub. ((United Kingdom) Oxford)
issn 0934-0874
e-issn 1432-2277
Publication status Publié
Affiliations UCL - SSS/IREC/NEFR - Pôle de Néphrologie
UCL - (SLuc) Service de néphrologie
Keywords Transplantation ; BK virus ; Immunosuppression ; Kidney transplantation
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  1. Brennan Daniel C., Agha Irfan, Bohl Daniel L., Schnitzler Mark A., Hardinger Karen L., Lockwood Mark, Torrence Stephanie, Schuessler Rebecca, Roby Tiffany, Gaudreault-Keener Monique, Storch Gregory A., Incidence of BK with Tacrolimus Versus Cyclosporine and Impact of Preemptive Immunosuppression Reduction, 10.1111/j.1600-6143.2005.00742.x
  2. Bressollette-Bodin C., Coste-Burel M., Hourmant M., Sebille V., Andre-Garnier E., Imbert-Marcille B. M., A Prospective Longitudinal Study of BK Virus Infection in 104 Renal Transplant Recipients, 10.1111/j.1600-6143.2005.00934.x
  3. Alméras C., Vetromile F., Garrigue V., Szwarc I., Foulongne V., Mourad G., Monthly screening for BK viremia is an effective strategy to prevent BK virus nephropathy in renal transplant recipients : Monthly screening to prevent BKV nephropathy, 10.1111/j.1399-3062.2011.00619.x
  4. Koukoulaki M., Grispou E., Pistolas D., Balaska K., Apostolou T., Anagnostopoulou M., Tseleni-Kotsovili A., Hadjiconstantinou V., Paniara O., Saroglou G., Legakis N., Drakopoulos S., Prospective monitoring of BK virus replication in renal transplant recipients, 10.1111/j.1399-3062.2008.00342.x
  5. Thakur R., Arora S., Nada R., Minz M., Joshi K., Prospective monitoring of BK virus reactivation in renal transplant recipients in North India : BKV reactivation in renal transplantation, 10.1111/j.1399-3062.2011.00634.x
  6. Hirsch Hans H., Brennan Daniel C., Drachenberg Cinthia B., Ginevri Fabrizio, Gordon Jennifer, Limaye Ajit P., Mihatsch Michael J., Nickeleit Volker, Ramos Emilio, Randhawa Parmjeet, Shapiro Ron, Steiger Juerg, Suthanthiran Manikkam, Trofe Jennifer, Polyomavirus-Associated Nephropathy in Renal Transplantation: Interdisciplinary Analyses and Recommendations : , 10.1097/01.tp.0000156165.83160.09
  7. Mengel M., BK Virus Nephropathy Revisited, 10.1111/ajt.14358
  8. Drachenberg Cinthia B., Hirsch Hans H., Papadimitriou John C., Gosert Rainer, Wali Ravinder K., Munivenkatappa Raghava, Nogueira Joseph, Cangro Charles B., Haririan Abdolreza, Mendley Susan, Ramos Emilio, Polyomavirus BK Versus JC Replication and Nephropathy in Renal Transplant Recipients: A Prospective Evaluation : , 10.1097/01.tp.0000269706.59977.a5
  9. Ramos E., Clinical Course of Polyoma Virus Nephropathy in 67 Renal Transplant Patients, 10.1097/01.asn.0000023435.07320.81
  10. Wadei H. M., Rule A. D., Lewin M., Mahale A. S., Khamash H. A., Schwab T. R., Gloor J. M., Textor S. C., Fidler M. E., Lager D. J., Larson T. S., Stegall M. D., Cosio F. G., Griffin M. D., Kidney Transplant Function and Histological Clearance of Virus Following Diagnosis of Polyomavirus-Associated Nephropathy (PVAN) : Outcome of Polyomavirus Nephropathy, 10.1111/j.1600-6143.2006.01296.x
  11. Kuypers Dirk R. J., Management of polyomavirus-associated nephropathy in renal transplant recipients, 10.1038/nrneph.2012.64
  12. Hirsch H. H., Randhawa P., , BK Polyomavirus in Solid Organ Transplantation : BK Polyomavirus in Solid Organ Transplantation, 10.1111/ajt.12110
  13. Sawinski D., Goral S., BK virus infection: an update on diagnosis and treatment, 10.1093/ndt/gfu023
  14. Kasiske Bertram L., Zeier Martin G., Chapman Jeremy R., Craig Jonathan C., Ekberg Henrik, Garvey Catherine A., Green Michael D., Jha Vivekanand, Josephson Michelle A., Kiberd Bryce A., Kreis Henri A., McDonald Ruth A., Newmann John M., Obrador Gregorio T., Vincenti Flavio G., Cheung Michael, Earley Amy, Raman Gowri, Abariga Samuel, Wagner Martin, Balk Ethan M., KDIGO clinical practice guideline for the care of kidney transplant recipients: a summary, 10.1038/ki.2009.377
  15. Elfadawy Nissreen, Flechner Stuart M., Liu Xiaobo, Schold Jesse, Tian Devin, Srinivas Titte R., Poggio Emilio, Fatica Richard, Avery Robin, Mossad Sherif B., The impact of surveillance and rapid reduction in immunosuppression to control BK virus-related graft injury in kidney transplantation, 10.1111/tri.12134
  16. Weiss A. S., Gralla J., Chan L., Klem P., Wiseman A. C., Aggressive Immunosuppression Minimization Reduces Graft Loss Following Diagnosis of BK Virus-Associated Nephropathy: A Comparison of Two Reduction Strategies, 10.2215/cjn.05691207
  17. Hardinger K. L., Koch M. J., Bohl D. J., Storch G. A., Brennan D. C., BK-Virus and the Impact of Pre-Emptive Immunosuppression Reduction: 5-Year Results, 10.1111/j.1600-6143.2009.02952.x
  18. Hirsch Hans H., Knowles Wendy, Dickenmann Michael, Passweg Jakob, Klimkait Thomas, Mihatsch Michael J., Steiger Jürg, Prospective Study of Polyomavirus Type BK Replication and Nephropathy in Renal-Transplant Recipients, 10.1056/nejmoa020439
  19. Lamarche Caroline, Orio Julie, Collette Suzon, Senécal Lynne, Hébert Marie-Josée, Renoult Édith, Tibbles Lee Anne, Delisle Jean-Sébastien, BK Polyomavirus and the Transplanted Kidney : Immunopathology and Therapeutic Approaches, 10.1097/tp.0000000000001333
  20. Sawinski D., Forde K. A., Trofe-Clark J., Patel P., Olivera B., Goral S., Bloom R. D., Persistent BK Viremia Does Not Increase Intermediate-Term Graft Loss but Is Associated with De Novo Donor-Specific Antibodies, 10.1681/asn.2014010119
  21. Schaub S., Hirsch H. H., Dickenmann M., Steiger J., Mihatsch M. J., Hopfer H., Mayr M., Reducing Immunosuppression Preserves Allograft Function in Presumptive and Definitive Polyomavirus-Associated Nephropathy : Preservation of Allograft Function in BKV-Infection, 10.1111/j.1600-6143.2010.03310.x
  22. Ginevri F., Azzi A., Hirsch H. H., Basso S., Fontana I., Cioni M., Bodaghi S., Salotti V., Rinieri A., Botti G., Perfumo F., Locatelli F., Comoli P., Prospective Monitoring of Polyomavirus BK Replication and Impact of Pre-Emptive Intervention in Pediatric Kidney Recipients, 10.1111/j.1600-6143.2007.01984.x
  23. Everly Matthew J., Rebellato Lorita M., Haisch Carl E., Ozawa Miyuki, Parker Karen, Briley Kimberly P., Catrou Paul G., Bolin Paul, Kendrick William T., Kendrick Scott A., Harland Robert C., Terasaki Paul I., Incidence and Impact of De Novo Donor-Specific Alloantibody in Primary Renal Allografts : , 10.1097/tp.0b013e31827d62e3
  24. Amrouche Lucile, Aubert Olivier, Suberbielle Caroline, Rabant Marion, Van Huyen Jean-Paul Duong, Martinez Frank, Sberro-Soussan Rebecca, Scemla Anne, Tinel Claire, Snanoudj Renaud, Zuber Julien, Cavalcanti Ruy, Timsit Marc-Olivier, Lamhaut Lionel, Anglicheau Dany, Loupy Alexandre, Legendre Christophe, Long-term Outcomes of Kidney Transplantation in Patients With High Levels of Preformed DSA : The Necker High-Risk Transplant Program, 10.1097/tp.0000000000001650
  25. Solez K., Colvin R. B., Racusen L. C., Haas M., Sis B., Mengel M., Halloran P. F., Baldwin W., Banfi G., Collins A. B., Cosio F., David D. S. R., Drachenberg C., Einecke G., Fogo A. B., Gibson I. W., Glotz D., Iskandar S. S., Kraus E., Lerut E., Mannon R. B., Mihatsch M., Nankivell B. J., Nickeleit V., Papadimitriou J. C., Randhawa P., Regele H., Renaudin K., Roberts I., Seron D., Smith R. N., Valente M., Banff 07 Classification of Renal Allograft Pathology: Updates and Future Directions, 10.1111/j.1600-6143.2008.02159.x
  26. Loupy Alexandre, Lefaucheur Carmen, Vernerey Dewi, Prugger Christof, van Huyen Jean-Paul Duong, Mooney Nuala, Suberbielle Caroline, Frémeaux-Bacchi Véronique, Méjean Arnaud, Desgrandchamps François, Anglicheau Dany, Nochy Dominique, Charron Dominique, Empana Jean-Philippe, Delahousse Michel, Legendre Christophe, Glotz Denis, Hill Gary S., Zeevi Adriana, Jouven Xavier, Complement-Binding Anti-HLA Antibodies and Kidney-Allograft Survival, 10.1056/nejmoa1302506
  27. Wiebe C., Gibson I. W., Blydt-Hansen T. D., Karpinski M., Ho J., Storsley L. J., Goldberg A., Birk P. E., Rush D. N., Nickerson P. W., Evolution and Clinical Pathologic Correlations of De Novo Donor-Specific HLA Antibody Post Kidney Transplant : Clinical Pathologic Correlations of De Novo DSA, 10.1111/j.1600-6143.2012.04013.x
  28. Zafrani L., Truffaut L., Kreis H., Etienne D., Rafat C., Lechaton S., Anglicheau D., Zuber J., Ciroldi M., Thervet E., Snanoudj R., Mamzer M. F., Martinez F., Timsit M.O., Bergougnoux L., Legendre C., Incidence, Risk Factors and Clinical Consequences of Neutropenia Following Kidney Transplantation: A Retrospective Study, 10.1111/j.1600-6143.2009.02699.x
  29. Knoll G. A., Mycophenolate Mofetil Dose Reduction and the Risk of Acute Rejection after Renal Transplantation, 10.1097/01.asn.0000079616.71891.f5
  30. Gatault P., Kamar N., Büchler M., Colosio C., Bertrand D., Durrbach A., Albano L., Rivalan J., Le Meur Y., Essig M., Bouvier N., Legendre C., Moulin B., Heng A.-E., Weestel P.-F., Sayegh J., Charpentier B., Rostaing L., Thervet E., Lebranchu Y., Reduction of Extended-Release Tacrolimus Dose in Low-Immunological-Risk Kidney Transplant Recipients Increases Risk of Rejection and Appearance of Donor-Specific Antibodies: A Randomized Study, 10.1111/ajt.14109
  31. Zeng G., Huang Y., Huang Y., Lyu Z., Lesniak D., Randhawa P., Antigen-Specificity of T Cell Infiltrates in Biopsies With T Cell-Mediated Rejection and BK Polyomavirus Viremia: Analysis by Next Generation Sequencing, 10.1111/ajt.13911
  32. Dieplinger G., Everly M.J., Briley K.P., Haisch C.E., Bolin P., Maldonado A.Q., Kendrick W.T., Kendrick S.A., Morgan C., Terasaki P.I., Rebellato L.M., Onset and progression ofde novodonor-specific anti-human leukocyte antigen antibodies after BK polyomavirus and preemptive immunosuppression reduction, 10.1111/tid.12467
  33. Brokhof Marissa M., Sollinger Hans W., Hager David R., Muth Brenda L., Pirsch John D., Fernandez Luis A., Bellingham Janet M., Mezrich Joshua D., Foley David P., D’Alessandro Anthony M., Odorico Jon S., Mohamed Maha A., Vidyasagar Vijay, Ellis Thomas M., Kaufman Dixon B., Djamali Arjang, Antithymocyte Globulin Is Associated With a Lower Incidence of De Novo Donor-Specific Antibodies in Moderately Sensitized Renal Transplant Recipients : , 10.1097/tp.0000000000000031
  34. Liacini Abdelhamid, Seamone Mark E., Muruve Daniel A., Tibbles Lee Anne, Anti-BK Virus Mechanisms of Sirolimus and Leflunomide Alone and in Combination: Toward a New Therapy for BK Virus Infection : , 10.1097/tp.0b013e3182007be2
  35. Pascual Julio, Berger Stefan P., Witzke Oliver, Tedesco Helio, Mulgaonkar Shamkant, Qazi Yasir, Chadban Steven, Oppenheimer Federico, Sommerer Claudia, Oberbauer Rainer, Watarai Yoshihiko, Legendre Christophe, Citterio Franco, Henry Mitchell, Srinivas Titte R., Luo Wen-Lin, Marti AnaMaria, Bernhardt Peter, Vincenti Flavio, , Everolimus with Reduced Calcineurin Inhibitor Exposure in Renal Transplantation, 10.1681/asn.2018010009
  36. Suwelack, Am J Transplant, 18, 29 (2018)
  37. Lopez, Am J Transplant, 18, 207 (2018)
  38. Demey Baptiste, Tinez Claire, François Catherine, Helle François, Choukroun Gabriel, Duverlie Gilles, Castelain Sandrine, Brochot Etienne, Risk factors for BK virus viremia and nephropathy after kidney transplantation: A systematic review, 10.1016/j.jcv.2018.10.002
  39. Schachtner T., Stein M., Babel N., Reinke P., The Loss of BKV-specific Immunity From Pretransplantation to Posttransplantation Identifies Kidney Transplant Recipients at Increased Risk of BKV Replication : Immune Monitoring in BK Viremia, 10.1111/ajt.13252
  40. Solis Morgane, Velay Aurélie, Porcher Raphaël, Domingo-Calap Pilar, Soulier Eric, Joly Mélanie, Meddeb Mariam, Kack-Kack Wallys, Moulin Bruno, Bahram Siamak, Stoll-Keller Françoise, Barth Heidi, Caillard Sophie, Fafi-Kremer Samira, Neutralizing Antibody–Mediated Response and Risk of BK Virus–Associated Nephropathy, 10.1681/asn.2017050532
  41. Borni-Duval Claire, Caillard Sophie, Olagne Jérôme, Perrin Peggy, Braun-Parvez Laura, Heibel Françoise, Moulin Bruno, Risk Factors for BK Virus Infection in the Era of Therapeutic Drug Monitoring : , 10.1097/tp.0b013e3182921995
Bibliographic reference Devresse, Arnaud ; Tinel, Claire ; Vermorel, Agathe ; Snanoudj, Renaud ; Morin, Lise ; et. al. No clinical benefit of rapid versus gradual tapering of immunosuppression to treat sustained BK virus viremia after kidney transplantation: a single-center experience. In: Transplant International, Vol. 32, no. 5, p. 481-492 (2019)
Permanent URL http://hdl.handle.net/2078.1/210401