New insights in viral infections after kidney transplantation : focus on cytomegalovirus, norovirus and BK virus

This work aims to provide new insights in three frequent viral infections after kidney transplantation (KT). We show that the de novo use of an mTOR inhibitor based immunosuppressive regimen is associated with a decreased incidence of cytomegalovirus disease after KT compared to the standard of care. We demonstrate that Norovirus is the leading cause of infectious diarrhea after KT and that pre-existing conditions determine the primary functional long-term consequences after post-KT diarrhea. We show that an aggressive minimization of immunosuppression to treat sustained BK virus (BKV) viremia does not improve long-term graft outcome compared to a more gradual reduction, but is associated with an increased risk of developing de novo donor specific antibodies. Finally, we show that urinary tract infection, BKV viremia and BKV nephropathy increase the urinary levels of CXCL9 and CXCL10. These confounding factors must be addressed before urinary CXCL9 and CXCL10 can be used as noninvasive diagnostic markers of acute rejection.
(MED - Sciences médicales) -- UCL, 2021