Graft loss among renal-transplant recipients with early reduction of immunosuppression for BK viremia

Table 1 Demographics and outcomes n (%)

Variable	All sample (n = 319)	PyVAN negative (n = 272)	PyVAN positive (n = 47)
Age (mean, yr)	53	51	53.1
Male	210 (65.8)	177 (65.1)	33 (70.2)
Black	86 (27.0)	67 (24.6)	19 (40.4)
Diabetes mellitus	86 (27.0)	71 (26.1)	15 (32.0)
CMV D+/R-	58 (18.2)	49 (18.0)	9 (19.1)
DDKT	174 (54.5)	140 (51.5)	34 (72.3)
Induction immunosuppression
Thymoglobulin	118 (37.0)	97 (35.7)	21 (44.7)
Basiliximab	143 (44.8)	124 (45.6)	19 (40.4)
Daclizumab	56 (17.6)	50 (18.4)	6 (12.8)
Delayed graft function	58 (18.2)	47 (17.3)	11 (23.4)
Acute rejection	59 (18.5)	44 (16.2)	15 (32.0)
Graft loss	17 (5.3)	13 (4.8)	4 (8.5)
Death	21 (6.6)	15 (5.5)	6 (12.8)

DDKT: Deceased-donor kidney transplantation; PyVAN: Polyoma-virus associated nephropathy.

Table 2 Predictors of polyoma-virus associated nephropathy

Predictor	Univariate analysis			Multivariate analysis
	PyVAN negative (n = 272)	PyVAN positive (n = 47)	P value	OR	CI	P value
Age (mean, yr)	51	53.1	0.343
Male	177	33	0.493
Black race	67	19	0.024a	1.68	0.86-3.31	0.13
Diabetes mellitus	71	15	0.407
CMV D+/R-	49	9	0.839
DDKT	140	34	0.008a	2.24	1.1-4.54	0.03a
Thymoglobulin	97	21	0.237
Basiliximab	124	19	0.511
Daclizumab	50	6	0.412
Delayed graft function	47	11	0.315
Acute rejection	44	15	0.010a	2.42	1.19-4.29	0.02a
Graft loss	13	4
Death	16	6	0.112

^aP < 0.05. DDKT: Deceased-donor kidney transplantation; PyVAN: Polyoma-virus associated nephropathy.

Table 3 Protocol deviation among patients with presumptive polyoma-virus associated nephropathy¹

Patient	Time point of protocol deviation post-transplant	Target days between serial screening	Actual days between serial screening	BKVL change (copies/mL)
1	Month 1 to month 3	60 d	100 d	ND to 1065190
2	Month 1 to month 3	60 d	138 d	ND to 17478
3	Month 9 to month 12	90 d	214 d	< 1000 to 1076120
4	Month 6 to month 9	90 d	393 d	< 1000 to 1269650
5	Month 6 to month 9	90 d	113 d	ND to 57982
6	Month 1 to month 3	60 d	134 d	ND to 392527
7	Month 3 to month 6	90 d	133 d	ND to 627218
8	Month 3 to month 6	90 d	108 d	ND to 82354
9	DOT to month 1	30 d	121 d	157939 at month 1
10	Month 3 to month 6	90 d	137 d	ND to 74389
11	Month 1 to month 3	60 d	179 d	ND to 28592
12	Month 1 to month 3	60 d	94 d	ND to 39000
13	DOT to month 1	30 d	58 d	17558 at month 1

¹Three patients with < 10 d of deviation from protocol were not included. ND: Not detectable.