The clinical courses of BK polyomavirus nephropathy (BKPyVN) are variable. This study aimed to evaluate the usefulness of repeat donor-derived cell-free DNA (dd-cfDNA) monitoring in identifying clinical courses. Repeat allograft biopsy and dd-cfDNA monitoring were performed at 6-12 months post-intervention or when renal allograft dysfunction occurred. Results demonstrated that recipients with rejection had a higher plasma dd-cfDNA fraction (2.23% 1.17%, 5.52%; n = 13) than those with resolved BKPyVN (0.80% 0.66%, 0.91%; n = 30; p 1.12% following BKPyVN intervention could identify rejection (AUC = 0.924), and a urine dd-cfDNA concentration > 5.95 ng/mL could identify persistent BKPyVN (AUC = 0.840). In summary, repeat dd-cfDNA monitoring integrated with clinical data can serve as an adjunct to identify BKPyVN clinical courses.
Zhao et al. (Sun,) studied this question.