{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T08:03:12Z","timestamp":1779350592625,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>BK viremia is associated with worse kidney transplant function and de novo donor\u2010specific antibodies (DSA), but mortality and graft survival are not impacted in the short\u2010 and intermediate\u2010term. The long\u2010term impact of BK viremia remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a single\u2010center retrospective study on 1058 consecutive kidney or kidney\u2010pancreas transplant recipients. We classified the cohort based on the presence or absence of BK viremia, BK viral loads, persistence of BK viremia, and pre\u2010existing or de novo DSA. Outcomes included mortality, graft loss, death\u2010censored graft survival (DCGS), estimated glomerular filtration rate, biopsy\u2010proven acute rejection (BPAR), de novo DSA, ureteral stenosis, and genitourinary (GU) malignancies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over a median follow\u2010up period of 9.7\u00a0years, there was no difference in graft loss (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.08) and mortality (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.56). Time\u2010varying multivariable analysis showed no difference in DCGS [HR 1.02, (0.91\u20131.16)]. Compared to never BK viremic patients, patients with BK viremia had similar graft function at 5 and 10\u00a0years (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.09 and 0.65, respectively), rates of GU malignancies (7.0% vs. 5.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.35) and ureteral stenosis (0.8% vs. 0.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.63). Patients with BK viral loads &gt;10\u00a0000\u00a0copies\/mL had a higher risk of de novo DSA [HR 1.71, (1.08\u20132.68)] and BPAR [HR 2.11, (1.28\u20133.47)].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BK viremia did not impact mortality, graft loss, kidney function, GU malignancies, and ureteral stenosis over long\u2010term follow\u2010up, but BPAR episodes and development of de novo DSA were higher with viral loads &gt;10\u00a0000\u00a0copies\/mL. Strict monitoring protocols and immunosuppression reduction strategies are effective in minimizing the risk associated with BK viremia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70333","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:17:33Z","timestamp":1759882653000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Long\u2010Term Outcomes of BK Viremia in Kidney Transplant Recipients"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3745-7533","authenticated-orcid":false,"given":"Srijan","family":"Tandukar","sequence":"first","affiliation":[{"name":"Renal\u2010Electrolyte and Hypertension Division Hospital of the University of Pennsylvania  Philadelphia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qufei","family":"Wu","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Biostatistics University of Pennsylvania  Philadelphia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sneha","family":"Chandrashekar","sequence":"additional","affiliation":[{"name":"University of Pennsylvania  Philadelphia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Divyash","family":"Shah","sequence":"additional","affiliation":[{"name":"University of Pennsylvania  Philadelphia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chienhui","family":"Chiang","sequence":"additional","affiliation":[{"name":"Renal\u2010Electrolyte and Hypertension Division Hospital of the University of Pennsylvania  Philadelphia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Couch","sequence":"additional","affiliation":[{"name":"Renal\u2010Electrolyte and Hypertension Division Hospital of the University of Pennsylvania  Philadelphia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4370-3796","authenticated-orcid":false,"given":"Jennifer","family":"Trofe","sequence":"additional","affiliation":[{"name":"Renal\u2010Electrolyte and Hypertension Division Hospital of the University of Pennsylvania  Philadelphia USA"},{"name":"Department of Surgery Hospital of the University of Pennsylvania  Philadelphia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7886-017X","authenticated-orcid":false,"given":"Elizabeth M.","family":"Sonnenberg","sequence":"additional","affiliation":[{"name":"Department of Surgery Hospital of the University of Pennsylvania  Philadelphia USA"},{"name":"Leonard Davis Institute of Health Economics University of Pennsylvania  Philadelphia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8682-972X","authenticated-orcid":false,"given":"Peter","family":"Abt","sequence":"additional","affiliation":[{"name":"Department of Surgery Hospital of the University of Pennsylvania  Philadelphia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Ann","family":"Lim","sequence":"additional","affiliation":[{"name":"Renal\u2010Electrolyte and Hypertension Division Hospital of the University of Pennsylvania  Philadelphia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3307-8926","authenticated-orcid":false,"given":"Vishnu","family":"Potluri","sequence":"additional","affiliation":[{"name":"Renal\u2010Electrolyte and Hypertension Division Hospital of the University of Pennsylvania  Philadelphia USA"},{"name":"Leonard Davis Institute of Health Economics University of Pennsylvania  Philadelphia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roy","family":"Bloom","sequence":"additional","affiliation":[{"name":"Renal\u2010Electrolyte and Hypertension Division Hospital of the University of Pennsylvania  Philadelphia 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