Transplant Molecular Diagnostics

The Transplant Molecular Diagnostics Laboratory performs clinical testing to monitor transplant and other immunocompromised pediatric patients. Most of our tests incorporate quantitative real-time PCR technology that rapidly links amplification with detection and quantitation of viral DNA.

Antiviral therapy is instituted upon viral DNA detection, followed by close monitoring of quantitative viral titers to assess and maintain the balance between immunosuppression and anti-infective therapies.

Currently, our real-time PCR tests detect viral DNA loads that may be indicative of an active infection that may warrant the institution of antiviral therapies and/or a decrease of immunosuppressive therapies.

This laboratory is CLIA-certified.

The detection and monitoring of:

BK polyomavirus (BKV) quantitative real-time PCR

BK polyomavirus (BKV) is the primary etiological agent of polyomavirus-associated nephropathy (PVNA), which causes irreversible graft loss in 1% to 10% of kidney transplants (Hirsch 2005, Ramos et al., 2002). BKV-associated hemorrhagic cystitis is a major complication of bone marrow transplants (Arthur et al., 1988). Monitoring BKV DNA levels of urine and plasma by quantitative real-time PCR in these patients may allow timely recognition of virus reactivation and permit installment of antiviral treatment (IVIG and Levaquin® when identified in urine) and/or a decrease of immunosuppressive therapies.

References

Hirsch H. (2005). BK virus: opportunity makes a pathogen. Clin Infect Dis 41:354-360.

Ramos E, Drachenberg CB, Portocarrero M, Wali R, Klassen DK, Fink JC. Farney A, Hirsch H, Papadimitriou JC, Cangro CB, Weir MR, ST Bartlett ST. (2002). BK virus nephropathy diagnosis and treatment: experience at the University of Maryland renal transplant program. Clin Transpl 143-153

Arthur RR, Shah KV, Charache P, Saral R. (1988). BK and JC virus infections in recipients of bone marrow transplants. J Infect Dis 158:563-569.

Our research efforts are focused on development of new or improved laboratory-based assays to aid in the diagnosis and treatment of pediatric disorders.