COMPLICATIONS - INFECTIONS

D. Steubl¹, M. Baumann¹, M. Fischereder², B. Krämer³, U. Heemann¹, J. Lutz^1
1Department Of Nephrology, University hospital rechts der Isar, Munich, Munich/GERMANY, ²Medizinische Poliklinik Innenstadt, Klinkum der Ludwig-Maximilian-Universität, München, Munich/GERMANY, ³Medizinische Klinik I, Marienhospital Herne, Herne/GERMANY

Body: Background: BK-Virus (BKV)-infection is associated with a severe impairment of graft function and even graft loss. Some risk factors have benn identified.However, how to adapt the immunosuppressive therapy is not clear so far.

Methods: This retrospective study was performed at the transplant centers of the university hospitals in Munich and Regensburg. We compared 57 renal transplantrecipients with BKV-replication with 71 transplant recipients who had no BKV-replication to identify potential risk factors for the development of a BKV-infection. Furthermore, we compared outcomeand graft function in patients with BKV-replication, in whom mycophenolate (MMF) was discontinued with an additional dose reduction of the remaining immunosuppressants versus patients where MMF wasmaintained with a dose reduction of MMF together with the other immunosuppressants.

Results: Patients with BKV-infection received significantly more MMF (p<0.01), were more often on a triple-immunosuppression with tacrolimus (p<0.01,p=0.034), had a higher tacrolimus serum-concentration (p=0.002), a lower lymphocyte count (p=0.006), a longer warm ischemic time (p=0.019), were more often male (p=0.026). Patients in whom MMF wasstopped had a higher chance for a clearance of BKV infection (p=0.022). Furthermore, BKV-clearance was achieved quicker as compared to patients maintained on MMF (p=0.048). Graft function was betterand there were no graft losses in patients in whom MMF was discontinued (p=0.04).

Conclusions: MMF and Tacrolimus could play an important role in the development on BKV-infection after renal transplantation. Discontinuation of MMF with areduction of the remaining immunosuppression could be an option to interfere with the BKV-infection.

Disclosure: All authors have declared no conflicts of interest.