Abstract
BackgroundSome studies have suggested mizoribine (MZR) could inhibit the replication of BK polyomavirus (BKPyV). The purpose of this study was to explore whether conversion from mycophenolate mofetil (MMF) to MZR in the early stages of BKPyV infection can improve kidney allograft prognosis.MethodsTwenty-one kidney transplant recipients with BKPyV viruria/viremia and ten with BK polyomavirus-associated allograft nephropathy (BKPyVAN) received MZR conversion therapy were retrospectively identified. The clearance rate of urine and blood BKPyV DNA, change of serum creatinine (SCr), uric acid (UA), hemoglobin (HB), white blood cell (WBC), lymphocyte ratio, platelet (PLT), routine urinalysis, panel reactive antibody (PRA), and gastrointestinal disorders during follow-up of the 2 groups were evaluated and compared.ResultsAfter MZR conversion therapy, the clearance rate of urine and blood viral load in BKPyV viruria/viremia group were 85.7 and 100 %, while that in BKPyVAN were 40 and 87.5 %, respectively. Stable SCr were observed in all cases of BKPyV viruria/viremia group, while that of BKPyVAN was only 40 % (P < 0.001) and one even progressed to end-stage renal disease. The results of routine urinalysis in the two groups showed no significant changes before and after MZR conversion therapy. However, in BKPyV viruria/viremia group, four cases developed acute rejection and one had positive PRA-II but no donor specific antibody, requiring conversion back to MMF. Hyperuricemia was the common adverse effect of MZR.ConclusionsConversion from MMF to MZR could help clear BKPyV infection. As compared to BKPyVAN, patients who underwent initiation of MZR conversion therapy in the early stages of BKPyV infection maintained stable allograft function. Prospective studies with larger sample size are needed to ascertain this preliminary finding.
Highlights
Some studies have suggested mizoribine (MZR) could inhibit the replication of BK polyomavirus (BKPyV)
Previous studies have suggested conversion from mycophenolate mofetil (MMF) to MZR correlated with lower BKPyV viruria/viremia[14, 15]
The 2 groups showed no significant differences with regard to patient demographics, the type of allograft, number of HLA mismatch, documented delayed graft function (DGF) or acute rejection, use of immune induction therapy, baseline immunosuppressive regimens, Tac trough level, serum creatinine (SCr), uric acid (UA), white blood cell (WBC), lymphocyte ratio, HB, PLT and panel reactive antibody (PRA)
Summary
Some studies have suggested mizoribine (MZR) could inhibit the replication of BK polyomavirus (BKPyV). The purpose of this study was to explore whether conversion from mycophenolate mofetil (MMF) to MZR in the early stages of BKPyV infection can improve kidney allograft prognosis. BK polyomavirus-associated allograft nephropathy (BKPyVAN) has become a common post-transplant. During the conversion from MMF to MZR, the lower risk of virus infection might be associated with the reduced intensity of immunosuppression, which facilitates the immune system to kill the virus. Previous studies have suggested conversion from MMF to MZR correlated with lower BKPyV viruria/viremia[14, 15]. The objective of the current study was to explore whether conversion from MMF to MZR in the early stages of BKPyV infection can improve kidney allograft prognosis
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
