High grade urothelial carcinoma in kidney transplant patients with a history of BK viremia - Just a coincidence?

Publisher: Munksgaard Country of Publication: Denmark NLM ID: 8710240 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1399-0012 (Electronic) Linking ISSN: 09020063 NLM ISO Abbreviation: Clin Transplant Subsets: MEDLINE

Original Publication: Copenhagen : Munksgaard,

Kidney Transplantation*/adverse effects ; Kidney Transplantation*/methods ; Carcinoma, Transitional Cell*/etiology ; Polyomavirus Infections*/complications ; Polyomavirus Infections*/epidemiology ; Urinary Bladder Neoplasms*/etiology ; Tumor Virus Infections* ; Pancreas Transplantation* ; BK Virus*; Humans ; Viremia

Introduction: Kidney transplant recipients (KTR) have a three-to-four-fold increased risk of developing urothelial carcinoma (UC) compared to the general population. BK polyoma virus (BKV) infection is known to affect approximately 15% of KTR. In vitro models support a potential pathogenic role for BKV in the development of UC. We describe a series of UC in kidney transplant recipients.
Methods: Electronic patient records were searched to identify KTR with UC who had undergone kidney only or simultaneous kidney and pancreas transplantation in a single UK center between 2009 and 2015. Where available, stored pathological samples were retrieved, re-examined and stained for SV40 as a marker of BKV using standard staining protocols for kidney biopsy samples.
Results: Fourteen KTR had developed UC post-transplant. Of these, 10 KTR had a history of BKV infection post-transplant. Six of these 10 KTR developed a rare micropapillary tumor subtype of UC which is typically only found in <1% of UC cases. All six micropapillary tumor samples stained positive for SV40, including samples from metastases. Three tumor samples were available from the four KTR with no history of BKV infection and were not micropapillary subtype and were negative for SV40. Three micropapillary tumors from immunocompetent patients were examined as controls and were negative for SV40.
Conclusions: These findings would support a pathogenic role for BK virus in the development of rare micropapillary subtype urothelial tumors in the kidney transplant population.
(© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

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Keywords: BK virus; kidney transplant; micropapillary tumor; urothelial cancer

Date Created: 20230831 Date Completed: 20231216 Latest Revision: 20240418

20240418

10.1111/ctr.15113

37650442