Urinary and plasma donor-derived cell-free DNA for noninvasive monitoring of BK polyomavirus-associated nephropathy in kidney transplant recipients: a prospective cohort study
Background BK polyomavirus-associated nephropathy (BKPyVAN) is a major cause of allograft injury and dysfunction in kidney transplant recipients. Current monitoring tools, including viremia and biopsy, have limitations in sensitivity, invasiveness, and timing.Objective To evaluate donor-derived cell...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2025-12-01
|
| Series: | Renal Failure |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2025.2521452 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849430853113872384 |
|---|---|
| author | Luying Guo Sulin Luo Rongfang Shen Pengpeng Yan Meifang Wang Tianlu Zhang Junhao Lv Guangjun Liu Hongfeng Huang Zhimin Chen Huiping Wang Wenhan Peng Jianyong Wu Jianghua Chen Rending Wang |
| author_facet | Luying Guo Sulin Luo Rongfang Shen Pengpeng Yan Meifang Wang Tianlu Zhang Junhao Lv Guangjun Liu Hongfeng Huang Zhimin Chen Huiping Wang Wenhan Peng Jianyong Wu Jianghua Chen Rending Wang |
| author_sort | Luying Guo |
| collection | DOAJ |
| description | Background BK polyomavirus-associated nephropathy (BKPyVAN) is a major cause of allograft injury and dysfunction in kidney transplant recipients. Current monitoring tools, including viremia and biopsy, have limitations in sensitivity, invasiveness, and timing.Objective To evaluate donor-derived cell-free DNA (dd-cfDNA) in urine and plasma as a dynamic, noninvasive biomarker for monitoring treatment response and predicting rejection risk in patients with biopsy-proven BKPyVAN.Methods In this prospective cohort study, 25 kidney transplant recipients with biopsy-proved BKPyVAN were enrolled and stratified into two cohorts: conventional immunosuppression reduction (CISR, n = 20) and early immunosuppression reduction (EISR, n = 5). A total of 224 urine and plasma samples were collected before biopsy and at 1, 2, 3, and 6 months post-biopsy. dd-cfDNA levels were quantified and correlated with histological features and clinical outcomes.Results Urinary dd-cfDNA levels significantly declined in the CISR cohort by month 2 (p < 0.01), preceding changes in creatinine and BKPyV reads. In the EISR cohort, urinary dd-cfDNA levels remained stable, suggesting early therapeutic response. Plasma dd-cfDNA effectively identified acute rejection, with elevations in two CISR patients. Histologic injury patterns, including edema and cast formation, correlated with urinary dd-cfDNA concentrations (r = 0.44–0.51, p < 0.05).Conclusion Combined urinary and plasma dd-cfDNA measurements are promising for noninvasive, dynamic surveillance of BKPyVAN and rejection risk in kidney transplant recipients. Larger, multicenter studies are warranted to define clinical thresholds and standardize integration into immunosuppression management. |
| format | Article |
| id | doaj-art-d0a75d6e12a944e39a8229b61dffa308 |
| institution | Kabale University |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj-art-d0a75d6e12a944e39a8229b61dffa3082025-08-20T03:27:51ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492025-12-0147110.1080/0886022X.2025.2521452Urinary and plasma donor-derived cell-free DNA for noninvasive monitoring of BK polyomavirus-associated nephropathy in kidney transplant recipients: a prospective cohort studyLuying Guo0Sulin Luo1Rongfang Shen2Pengpeng Yan3Meifang Wang4Tianlu Zhang5Junhao Lv6Guangjun Liu7Hongfeng Huang8Zhimin Chen9Huiping Wang10Wenhan Peng11Jianyong Wu12Jianghua Chen13Rending Wang14Kidney Disease Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, ChinaKidney Disease Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, ChinaKidney Disease Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, ChinaKidney Disease Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, ChinaKidney Disease Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, ChinaKidney Disease Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, ChinaKidney Disease Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, ChinaKidney Disease Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, ChinaKidney Disease Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, ChinaKidney Disease Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, ChinaKidney Disease Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, ChinaKidney Disease Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, ChinaKidney Disease Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, ChinaKidney Disease Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, ChinaKidney Disease Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, ChinaBackground BK polyomavirus-associated nephropathy (BKPyVAN) is a major cause of allograft injury and dysfunction in kidney transplant recipients. Current monitoring tools, including viremia and biopsy, have limitations in sensitivity, invasiveness, and timing.Objective To evaluate donor-derived cell-free DNA (dd-cfDNA) in urine and plasma as a dynamic, noninvasive biomarker for monitoring treatment response and predicting rejection risk in patients with biopsy-proven BKPyVAN.Methods In this prospective cohort study, 25 kidney transplant recipients with biopsy-proved BKPyVAN were enrolled and stratified into two cohorts: conventional immunosuppression reduction (CISR, n = 20) and early immunosuppression reduction (EISR, n = 5). A total of 224 urine and plasma samples were collected before biopsy and at 1, 2, 3, and 6 months post-biopsy. dd-cfDNA levels were quantified and correlated with histological features and clinical outcomes.Results Urinary dd-cfDNA levels significantly declined in the CISR cohort by month 2 (p < 0.01), preceding changes in creatinine and BKPyV reads. In the EISR cohort, urinary dd-cfDNA levels remained stable, suggesting early therapeutic response. Plasma dd-cfDNA effectively identified acute rejection, with elevations in two CISR patients. Histologic injury patterns, including edema and cast formation, correlated with urinary dd-cfDNA concentrations (r = 0.44–0.51, p < 0.05).Conclusion Combined urinary and plasma dd-cfDNA measurements are promising for noninvasive, dynamic surveillance of BKPyVAN and rejection risk in kidney transplant recipients. Larger, multicenter studies are warranted to define clinical thresholds and standardize integration into immunosuppression management.https://www.tandfonline.com/doi/10.1080/0886022X.2025.2521452BKPyVANkidney transplantationdonor-derived cell-free DNAallograft rejectiondynamic surveillance |
| spellingShingle | Luying Guo Sulin Luo Rongfang Shen Pengpeng Yan Meifang Wang Tianlu Zhang Junhao Lv Guangjun Liu Hongfeng Huang Zhimin Chen Huiping Wang Wenhan Peng Jianyong Wu Jianghua Chen Rending Wang Urinary and plasma donor-derived cell-free DNA for noninvasive monitoring of BK polyomavirus-associated nephropathy in kidney transplant recipients: a prospective cohort study Renal Failure BKPyVAN kidney transplantation donor-derived cell-free DNA allograft rejection dynamic surveillance |
| title | Urinary and plasma donor-derived cell-free DNA for noninvasive monitoring of BK polyomavirus-associated nephropathy in kidney transplant recipients: a prospective cohort study |
| title_full | Urinary and plasma donor-derived cell-free DNA for noninvasive monitoring of BK polyomavirus-associated nephropathy in kidney transplant recipients: a prospective cohort study |
| title_fullStr | Urinary and plasma donor-derived cell-free DNA for noninvasive monitoring of BK polyomavirus-associated nephropathy in kidney transplant recipients: a prospective cohort study |
| title_full_unstemmed | Urinary and plasma donor-derived cell-free DNA for noninvasive monitoring of BK polyomavirus-associated nephropathy in kidney transplant recipients: a prospective cohort study |
| title_short | Urinary and plasma donor-derived cell-free DNA for noninvasive monitoring of BK polyomavirus-associated nephropathy in kidney transplant recipients: a prospective cohort study |
| title_sort | urinary and plasma donor derived cell free dna for noninvasive monitoring of bk polyomavirus associated nephropathy in kidney transplant recipients a prospective cohort study |
| topic | BKPyVAN kidney transplantation donor-derived cell-free DNA allograft rejection dynamic surveillance |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2025.2521452 |
| work_keys_str_mv | AT luyingguo urinaryandplasmadonorderivedcellfreednafornoninvasivemonitoringofbkpolyomavirusassociatednephropathyinkidneytransplantrecipientsaprospectivecohortstudy AT sulinluo urinaryandplasmadonorderivedcellfreednafornoninvasivemonitoringofbkpolyomavirusassociatednephropathyinkidneytransplantrecipientsaprospectivecohortstudy AT rongfangshen urinaryandplasmadonorderivedcellfreednafornoninvasivemonitoringofbkpolyomavirusassociatednephropathyinkidneytransplantrecipientsaprospectivecohortstudy AT pengpengyan urinaryandplasmadonorderivedcellfreednafornoninvasivemonitoringofbkpolyomavirusassociatednephropathyinkidneytransplantrecipientsaprospectivecohortstudy AT meifangwang urinaryandplasmadonorderivedcellfreednafornoninvasivemonitoringofbkpolyomavirusassociatednephropathyinkidneytransplantrecipientsaprospectivecohortstudy AT tianluzhang urinaryandplasmadonorderivedcellfreednafornoninvasivemonitoringofbkpolyomavirusassociatednephropathyinkidneytransplantrecipientsaprospectivecohortstudy AT junhaolv urinaryandplasmadonorderivedcellfreednafornoninvasivemonitoringofbkpolyomavirusassociatednephropathyinkidneytransplantrecipientsaprospectivecohortstudy AT guangjunliu urinaryandplasmadonorderivedcellfreednafornoninvasivemonitoringofbkpolyomavirusassociatednephropathyinkidneytransplantrecipientsaprospectivecohortstudy AT hongfenghuang urinaryandplasmadonorderivedcellfreednafornoninvasivemonitoringofbkpolyomavirusassociatednephropathyinkidneytransplantrecipientsaprospectivecohortstudy AT zhiminchen urinaryandplasmadonorderivedcellfreednafornoninvasivemonitoringofbkpolyomavirusassociatednephropathyinkidneytransplantrecipientsaprospectivecohortstudy AT huipingwang urinaryandplasmadonorderivedcellfreednafornoninvasivemonitoringofbkpolyomavirusassociatednephropathyinkidneytransplantrecipientsaprospectivecohortstudy AT wenhanpeng urinaryandplasmadonorderivedcellfreednafornoninvasivemonitoringofbkpolyomavirusassociatednephropathyinkidneytransplantrecipientsaprospectivecohortstudy AT jianyongwu urinaryandplasmadonorderivedcellfreednafornoninvasivemonitoringofbkpolyomavirusassociatednephropathyinkidneytransplantrecipientsaprospectivecohortstudy AT jianghuachen urinaryandplasmadonorderivedcellfreednafornoninvasivemonitoringofbkpolyomavirusassociatednephropathyinkidneytransplantrecipientsaprospectivecohortstudy AT rendingwang urinaryandplasmadonorderivedcellfreednafornoninvasivemonitoringofbkpolyomavirusassociatednephropathyinkidneytransplantrecipientsaprospectivecohortstudy |