{"doi":"10.1111/tid.12467","title":"Onset and progression of <i>de novo</i> donor‐specific anti‐human leukocyte antigen antibodies after <scp>BK</scp> polyomavirus and preemptive immunosuppression reduction","abstract":"<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p><jats:styled-content style=\"fixed-case\">BK</jats:styled-content> polyomavirus (<jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV) viremia/nephropathy and reduction in immunosuppression following viremia may increase the risk of alloimmune activation and allograft rejection. This study investigates the impact of <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV viremia on <jats:italic>de novo</jats:italic> donor anti‐human leukocyte antigen (<jats:styled-content style=\"fixed-case\">HLA</jats:styled-content>)‐specific antibodies (dn<jats:styled-content style=\"fixed-case\">DSA</jats:styled-content>).</jats:p></jats:sec><jats:sec><jats:title>Patients and methods</jats:title><jats:p>All primary renal transplants at East Carolina University from March 1999 to December 2010, with at least 1 post‐transplant <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV viral load testing, were analyzed. Patients were negative for anti‐<jats:styled-content style=\"fixed-case\">HLA</jats:styled-content> antibodies to donor antigens (tested via single antigen beads) at transplantation and at first <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV testing.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Nineteen of 174 patients (11%) tested positive for <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV viremia. Within 24 months of <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV viremia detection, 79% of <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV‐viremic patients developed dn<jats:styled-content style=\"fixed-case\">DSA</jats:styled-content>. Only 20% of <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV viremia‐persistent cases, compared to 86% of <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV viremia‐resolved cases, developed dn<jats:styled-content style=\"fixed-case\">DSA</jats:styled-content> (<jats:italic>P</jats:italic> = 0.03). Poor allograft survival was evident in <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV viremia‐persistent patients (60% failure by 2 years post <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV diagnosis) and in <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV viremia‐resolved patients with dn<jats:styled-content style=\"fixed-case\">DSA</jats:styled-content> (5‐year post <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV diagnosis allograft survival of 48%).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Post‐transplant <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV viremia and preemptive immunosuppression reduction is associated with high rates of dn<jats:styled-content style=\"fixed-case\">DSA</jats:styled-content>. When preemptively treating <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV viremia, dn<jats:styled-content style=\"fixed-case\">DSA</jats:styled-content> should be monitored to prevent allograft consequences.</jats:p></jats:sec>","journal":"Transplant Infectious Disease","year":2015,"id":687029,"datarank":0.5416376868966337,"base_score":3.6109179126442243,"endowment":3.6109179126442243,"self_citation_contribution":0.5416376868966337,"citation_network_contribution":0.0,"self_endowment_contribution":0.5416376868966337,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":36,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1794833,"name":"M.J. Everly","orcid":null,"position":1,"is_corresponding":false},{"id":1794834,"name":"K.P. Briley","orcid":null,"position":2,"is_corresponding":false},{"id":1794835,"name":"C.E. Haisch","orcid":null,"position":3,"is_corresponding":false},{"id":1794836,"name":"P. Bolin","orcid":null,"position":4,"is_corresponding":false},{"id":1794837,"name":"A.Q. Maldonado","orcid":null,"position":5,"is_corresponding":false},{"id":1794838,"name":"W.T. Kendrick","orcid":null,"position":6,"is_corresponding":false},{"id":1794839,"name":"S.A. Kendrick","orcid":null,"position":7,"is_corresponding":false},{"id":1794840,"name":"C. Morgan","orcid":null,"position":8,"is_corresponding":false},{"id":1794844,"name":"P.I. Terasaki","orcid":null,"position":9,"is_corresponding":false},{"id":1794845,"name":"L.M. Rebellato","orcid":null,"position":10,"is_corresponding":false},{"id":1794832,"name":"G. Dieplinger","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Onset and progression of <i>de novo</i> donor‐specific anti‐human leukocyte antigen antibodies after <scp>BK</scp> polyomavirus and preemptive immunosuppression reduction","abstract":"<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p><jats:styled-content style=\"fixed-case\">BK</jats:styled-content> polyomavirus (<jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV) viremia/nephropathy and reduction in immunosuppression following viremia may increase the risk of alloimmune activation and allograft rejection. This study investigates the impact of <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV viremia on <jats:italic>de novo</jats:italic> donor anti‐human leukocyte antigen (<jats:styled-content style=\"fixed-case\">HLA</jats:styled-content>)‐specific antibodies (dn<jats:styled-content style=\"fixed-case\">DSA</jats:styled-content>).</jats:p></jats:sec><jats:sec><jats:title>Patients and methods</jats:title><jats:p>All primary renal transplants at East Carolina University from March 1999 to December 2010, with at least 1 post‐transplant <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV viral load testing, were analyzed. Patients were negative for anti‐<jats:styled-content style=\"fixed-case\">HLA</jats:styled-content> antibodies to donor antigens (tested via single antigen beads) at transplantation and at first <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV testing.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Nineteen of 174 patients (11%) tested positive for <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV viremia. Within 24 months of <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV viremia detection, 79% of <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV‐viremic patients developed dn<jats:styled-content style=\"fixed-case\">DSA</jats:styled-content>. Only 20% of <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV viremia‐persistent cases, compared to 86% of <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV viremia‐resolved cases, developed dn<jats:styled-content style=\"fixed-case\">DSA</jats:styled-content> (<jats:italic>P</jats:italic> = 0.03). Poor allograft survival was evident in <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV viremia‐persistent patients (60% failure by 2 years post <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV diagnosis) and in <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV viremia‐resolved patients with dn<jats:styled-content style=\"fixed-case\">DSA</jats:styled-content> (5‐year post <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV diagnosis allograft survival of 48%).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Post‐transplant <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV viremia and preemptive immunosuppression reduction is associated with high rates of dn<jats:styled-content style=\"fixed-case\">DSA</jats:styled-content>. When preemptively treating <jats:styled-content style=\"fixed-case\">BKP</jats:styled-content>yV viremia, dn<jats:styled-content style=\"fixed-case\">DSA</jats:styled-content> should be monitored to prevent allograft consequences.</jats:p></jats:sec>","is_dataset_classified":null,"base_score":3.6109179126442243,"endowment":3.6109179126442243,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"26442607","pmcid":null,"openalex_id":"https://openalex.org/W2177348258","authors":[],"funders":[{"funder_name":"Novartis","grant_id":"","title":null},{"funder_name":"Astellas Pharma US","grant_id":"","title":null}],"total_grants":2,"fwci":1.7097,"citation_percentile":0.86274414,"influential_citations":0,"citation_trend":[{"year":2016,"count":2},{"year":2017,"count":4},{"year":2018,"count":6},{"year":2019,"count":2},{"year":2020,"count":4},{"year":2021,"count":4},{"year":2022,"count":2},{"year":2023,"count":2},{"year":2024,"count":7},{"year":2025,"count":2}],"oa_status":"closed","license":"http://onlinelibrary.wiley.com/termsAndConditions#vor","oa_locations":[{"url":"https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Ftid.12467","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/tid.12467","host_type":"publisher"},{"url":"https://doi.org/10.1111/tid.12467","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/26442607","host_type":"repository"}],"fields_of_study":["Polyomavirus and related diseases","Animal Virus Infections Studies","Parvovirus B19 Infection Studies","Adult","Antibodies","BK Virus","Dose-Response Relationship, Drug","Female","HLA Antigens","Humans","Immunosuppression Therapy","Immunosuppressive Agents","Kidney Transplantation","Male","Middle Aged","Polyomavirus Infections","Tumor Virus Infections","Viremia"],"mesh_terms":["Adult","Antibodies","BK Virus","Dose-Response Relationship, Drug","Female","HLA Antigens","Humans","Immunosuppression Therapy","Immunosuppressive Agents","Male","Middle Aged","Tumor Virus Infections","Viremia","Kidney Transplantation","Polyomavirus Infections"],"keywords":["Viremia","Immunosuppression","Medicine","Immunology","Polyomavirus Infections","BK virus","Human leukocyte antigen","Antibody","Transplantation","Virology","Antigen","Kidney transplantation","Internal medicine","Polyomavirus","Bk","Anti-human Leukocyte Antigen Antibody"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-18T21:08:38.938158Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}