DETECTION OF VIRAL NUCLEIC ACIDS IN RENAL GRAFT PRESERVATION AND WASHING SOLUTIONS PREDICT THE OCCURRENCE OF POST-TRANSPLANT INFECTIONS

BackgroundIn pediatric kidney transplant recipients, viral infections occur soon after transplant and may be transmitted from the graft MethodsThis study of 75 pediatric kidney transplants investigated whether genome sequences of parvovirus B19, Epstein-Barr virus (EBV), human cytomegalovirus (HCMV), and BK polyomavirus (BKV) could be detected in kidney graft samples (graft biopsy samples and preservation and washing solutions) collected before implantation and whether their presence was a risk factor for infections in the recipient ResultsB19 DNA was detected in ∼30% of graft biopsy samples, preservation solutions, and washing solutions; EBV DNA was detected in ∼20% of preservation and washing solutions but rarely in biopsy samples; and HCMV DNA and BKV DNA were rarely detected in graft biopsy samples. Seronegative recipients of B19 DNA–positive and EBV DNA–positive grafts had a significantly higher risk of infection during the early posttransplant period than did recipients of negative grafts. In particular, none of the B19-seronegative recipients of B19 DNA–negative grafts experienced infection soon after transplant, whereas most recipients of B19 DNA–positive grafts experienced infection within the first month after transplant ConclusionsMolecular testing of donor grafts for viruses that infect circulating and resident cells in the graft—such as B19 in the kidney—could be useful (in association with donor/recipient serostatus) for identifying recipients at high risk for posttransplant infections