ASSOCIATION OF PRE-TRANSPLANT LYMPHOCYTE SUBSET WITH THE INCIDENCE OF CMV AND BKV VIREMIA AMONG KIDNEY TRANSPLANT RECIPIENTS

 

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https://storage.unitedwebnetwork.com/files/1099/d1e79d623bfa78b804fe5c936c456b3e.pdf
ASSOCIATION OF PRE-TRANSPLANT LYMPHOCYTE SUBSET WITH THE INCIDENCE OF CMV AND BKV VIREMIA AMONG KIDNEY TRANSPLANT RECIPIENTS

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Elisya Liyana
Abdullah
Maisarah Jalalonmuhali mai_jalal@yahoo.com University Malaya Medical Centre Medical department Kuala Lumpur Malaysia -
Elisya Liyana Abdullah drelisya@gmail.com University Malaya Medical Centre Medical department Kuala Lumpur Malaysia *
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Cytomegalovirus (CMV) and BK virus (BKV) reactivation remain a challenge for post-kidney transplant recipients. CMV viremia can cause systemic inflammation and immune dysregulation, ultimately leading to allograft rejection. Meanwhile, BKV reactivation can directly damage renal tubular cells, resulting in nephropathy and graft loss. Pre-transplant viral screening of donors and recipients helps assess patient risk and allows for prophylactic treatment of those at high risk. However, immune profiling with lymphocyte subsets may enable more personalized immunosuppressive regimens and preemptive strategies to reduce viral reactivation after kidney transplantation. Existing literature highlights a possible connection between pre-transplant lymphocyte subset profiles and subsequent CMV and BKV viremia, emphasizing immune profiling as a potential biomarker for viral reactivation. 

This is a retrospective study looking at 100 kidney transplant recipients in the University Malaya Medical Centre (UMMC) and the University Malaya Specialist Centre (UMSC) from 2021 and 2024. Pre-transplant lymphocyte subset and incidence of CMV and BKV viremia at 1, 3, and 6 months after kidney transplantation are recorded. Data are collected from the electronic medical record. 

The data will be analysed using IBM SPSS Statistics v.24 (Chicago, IL, USA). Continuous variables will be summarized by descriptive statistics such as mean, median, standard deviation and interquartile range while categorical variables will be expressed as frequencies and percentages. Intragroup changes will be analyzed by using ANOVA test. For between-group comparisons, either Pearson Chi-square or Fisher’s exact test will be used for categorical variables, whilst independent t-test (parametric) or Mann-Whitney test/ Wilcoxon signed rank sum analysis (non-parameteric) will be performed for continuous variables. A two-tailed p value of less than 0.05 is considered to be statistically significant. 

The incidence of CMV viremia is 11% in the first month after kidney transplant, 5.1% in month 3, and 9.1% in month 6. The incidence of BKV viremia is 1% in month 1, 0% in month 3, and 2% in month 6. Overall, there are no statistically significant differences in lymphocyte subsets between patients who did or did not develop CMV and BKV viremia at months 1, 3, and 6 post-transplant. 

 

The study showed limited evidence for a strong relationship between lymphocyte subsets and CMV and BKV viremia. However, in the setting of low BKV and moderate CMV burden, this may limit the power to detect clinical significance. 

This abstract was previously presented at the Malaysian Society of Nephrology (MSN) meeting, and its re-submission is permitted by the original meeting organizers.

Kewords