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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Parvovirus B19 status in liver, kidney and pancreas transplant candidates: A single center experience
Bojana Simunov, Anna Mrzljak, Zeljka Jurekovic, Snjezana Zidovec Lepej, Ana Bainrauch, Jadranka Pavicic Saric, Zeljka Hruskar, Leona Radmanic, Tatjana Vilibic-Cavlek
Bojana Simunov, Zeljka Jurekovic, Department of Nephrology, Merkur University Hospital, Zagreb 10000, Croatia
Anna Mrzljak, Department of Gastroenterology and Hepatology, University Clinical Hospital Zagreb, Zagreb 10000, Croatia
Anna Mrzljak, Tatjana Vilibic-Cavlek, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
Snjezana Zidovec Lepej, Leona Radmanic, Department of Immunological and Molecular Diagnostics, University Hospital for Infectious Diseases “Dr. Fran Mihaljevic”, Zagreb 10000, Croatia
Ana Bainrauch, Department of Medicine, Merkur University Hospital, Zagreb 10000, Croatia
Jadranka Pavicic Saric, Department of Anesthesiology, Merkur University Hospital, Zagreb 10000, Croatia
Zeljka Hruskar, Tatjana Vilibic-Cavlek, Department of Virology, Croatian Institute of Public Health, Zagreb 10000, Croatia
Author contributions: Simunov B contributed to the concept of the study, collected and analyzed the data, and wrote the original draft; Jurekovic Z, Zidovec Lepej S, Bainaruch A, Pavicic Saric J, Hruskar Z, and Radmanic L analyzed the data; Mrzljak A and Vilibic-Cavlek T made contributions to the concept of the study, and revised the manuscript critically; all authors approved the final version of the manuscript.
Supported by the Croatian Science Foundation Project, No. IP-2020-02-7407.
Institutional review board statement: The study was reviewed and approved by the Ethic Committee of the School of Medicine University of Zagreb (Approval No. 641-01/20-02/01).
Informed consent statement: Written informed consent was obtained from all participants included in the study.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No data sharing available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Anna Mrzljak, MD, PhD, Professor, Department of Gastroenterology and Hepatology, University Clinical Hospital Zagreb, 12 Kispaticeva, Zagreb 10000, Croatia. anna.mrzljak@gmail.com
Received: July 24, 2022
Peer-review started: July 24, 2022
First decision: August 22, 2022
Revised: September 5, 2022
Accepted: September 22, 2022
Article in press: September 22, 2022
Published online: November 18, 2022
BACKGROUND
Parvovirus B19 (B19V) is associated with a wide range of clinical manifestations. The major presentation is erythema infectiosum. However, a persistent infection may cause pure red cell aplasia and chronic anemia in immunocompromized patients. The B19V seroprevalence varies with age and geographical location.
AIM
To determine the B19V serological status and DNAemia in kidney, liver, and pancreas transplant candidates.
METHODS
Patients who underwent kidney, liver, or simultaneous kidney and pancreas/liver transplantation between January 2021 and May 2022 were included in the study. The serum samples were collected before transplantation. For detection of B19V DNA, a LightMix Kit B19V EC (TIB MOLBIOL, Berlin, Germany) was used. B19V IgM and IgG antibodies were detected using a commercial ELISA test (Euroimmun, Lübeck, Germany).
RESULTS
One hundred and thirty-one transplant candidates were included in the study, 71.0% male, with an average age of 53.27 years ± 12.71 years. There were 68.7% liver, 27.5% kidney, 3.0% simultaneous pancreas/kidney transplant (SPKT), and 0.8% simultaneous liver/kidney transplant recipients. No patients had detectable B19V DNA. B19V IgG seroprevalence was 77.1%. No acute or recent infections were detected (IgM antibodies). There was no difference in the mean age of seronegative and seropositive patients (51.8 years ± 12.9 years vs 53.7 years ± 12.7 years, t = -0.603; P = 0.548). Although seropositivity was lower in patients aged less than 30 years (66.6%) compared to the patients aged 30-59 years and > 60 years (80.4% and 78.1%, respectively), this difference was not significant. In addition, there was no difference in seropositivity between male and female transplant candidates, 76.3% and 78.9% (χ2 = 0.104; P = 0.748). The seroprevalence did not differ among organ recipients, with 77.8%, 80.6%, and 50.0% for liver, kidney, and SPKT, respectively, (χ2 = 5.297; P = 0.151). No significant difference was found in the seroprevalence in kidney transplant patients according to dialysis modality. Seroprevalence was 71.1% in hemodialysis patients, and 100% in peritoneal dialysis patients (χ2 = 0.799; P = 0.372).
CONCLUSION
The B19V seroprevalence is expectedly high among kidney, liver, and pancreas transplant candidates, but there are still 22.9% of seronegative individuals who remain at risk for primary disease and severe manifestations. Further research should elucidate the necessity of B19V screening in peri-transplant management.
Core Tip: Many liver, kidney, or pancreas transplant recipients are parvovirus B19 seronegative and at risk for primary disease and severe manifestations. Serological studies on pretransplant could simplify the diagnostic work-up of anemia after transplantation in these complex patients.
