1. ¹Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
2. ²Division of Transplantation Surgery, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, USA

Correspondence: MD Griffin, Mayo Clinic, Division of Nephrology and Hypertension, 200 First St SW, Charlton 10 Transplant Center, Rochester, Minnesota 55905, USA. E-mail: griffin.matthew@mayo.edu

Received 20 March 2006; Revised 31 January 2007; Accepted 21 February 2007; Published online 4 April 2007.

Abstract

Polyomavirus-associated nephropathy (PVAN) is a frequent cause of kidney transplant failure. We determined the risk factors for biopsy-proven PVAN among 1027 recent kidney transplant recipients by univariate and multivariate analyses. The rate of PVAN was determined over an univariate and multivariate analysis over an average of 30 months of follow-up of patients receiving predominantly living donor grafts with antibody induction and sequential surveillance biopsies to detect subclinical graft disease. Seventy-four transplant recipients were diagnosed with PVAN with the finding made on surveillance biopsy in 40 patients. These 40 cases did not differ from the 34 non-surveillance cases with respect to baseline clinical characteristics or initial histological features. Older recipient age and female donor gender were independent risks associated with PVAN. Factors not linked to PVAN risk included the use and type of induction agent, use of tacrolimus vs sirolimus, the number of human lympocyte antigen (HLA) mismatches, or the frequency of acute rejection. We conclude that PVAN preferentially affects older age patients and allografts from female donors but is unrelated to immunological risk, choice of immunosuppression, or rejection history.