Faculty Collaboration Database

Polyoma virus infection after renal transplantation. Use of immunostaining as a guide to diagnosis. Transplantation 2001 Apr 15;71(7):896-9

Date

05/15/2001

Pubmed ID

11349723

DOI

10.1097/00007890-200104150-00013

Scopus ID

2-s2.0-0035870629 (requires institutional sign-in at Scopus site)   121 Citations

Abstract

BACKGROUND: Polyoma virus infection is characterized by lymphocytic interstitial infiltrate in the kidney, and it mimics acute rejection. The purpose of this study is to estimate renal allograft outcome with this infection and characterize the lymphocytic infiltrates in polyoma virus-infected renal allografts.

METHODS: Patients who had polyoma virus inclusions in renal allograft biopsies were identified. Other viral inclusions were excluded by immunohistochemistry. The lymphocytic infiltrates of six cases of polyoma virus infection were compared with six cases of definite acute rejection by immunostaining for T and B cells.

RESULTS: There were 10 cases of polyoma virus infections in renal transplant recipients. Immunosuppressants consisted of mycophenolate mofetil with tacrolimus in eight cases and mycophenolate mofetil with cyclosporine in two. The median time of diagnosis of polyoma virus infection after transplantation was 9.5 months, and the time to graft failure after the diagnosis was 4 months. Reduced allograft survival was seen in patients who had polyoma virus infection. Immunostaining for T and B cells revealed marked increase in the B cells (CD20) in renal allografts with polyoma virus infection of 21% (range, 5-40%) compared with 6% (range, 0-10%) in those with acute rejection (P=0.039). Reduced cytotoxic T cells (TIA-1: median, 7%; range, 2-15%) were seen in polyoma virus-infected allografts compared with 24% (range, 15-30%) in those patients who had acute rejection (P=0.0159).

CONCLUSION: Irreversible graft failure is more prevalent with polyoma virus infection. Enhanced immunosuppressants with mycophenolate mofetil with tacrolimus may play a role in the development of this infection. An increase in CD20 and a decrease in cytotoxic T cells in allografts is characteristic of polyoma virus infection.

Author List

Ahuja M, Cohen EP, Dayer AM, Kampalath B, Chang CC, Bresnahan BA, Hariharan S

Author

Barbara A. Bresnahan MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acute Disease
Adult
Antigens, CD20
B-Lymphocytes
Female
Graft Rejection
Graft Survival
Humans
Immunohistochemistry
Immunosuppressive Agents
Kidney
Kidney Transplantation
Lymphocyte Count
Male
Middle Aged
Mycophenolic Acid
Papillomavirus Infections
Polyomavirus
Staining and Labeling
T-Lymphocytes, Cytotoxic
Tacrolimus
Tumor Virus Infections