Both donors and recipients prior to kidney transplantation are screened for viral pathogens but the tests used only work for recognised viruses. The authors were interested in using a metagenomic approach to assess virus transmission in living donor kidney transplantation. They enrolled living kidney donors and their recipients at the time of transplantation and followed them up at 4-6 weeks and then 1 year. 30 living kidney donor-recipient pairs were assessed. In addition to the usual viruses detected during routine post-transplant virus monitoring, the metagenomic sequencing also detected JC polyomavirus (JCPyV) in the urine of seven donors and their corresponding recipients. Phylogenetic analyses confirmed infection from the donor in six cases, suggesting transmission from the transplant donor can occur despite recipient seropositivity for JCPyV at the time of transplantation. Therefore metagenomic sequencing can be used to identify more frequent transmission of JCPyV from kidney transplant donors to recipients.
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