A systematic review and meta-analysis of enzyme-linked immunosorbent spot (ELISPOT) assay for BK polyomavirus immune response monitoring after kidney transplantation

BK virus (BKV) infection after kidney transplantation can cause BKV nephropathy (BKVAN) resulting in graft dysfunction and allograft loss. The treatment for BKVAN is reduction of the immunosuppressive load which increases risk transplant rejection. There no biomarker to monitor activity besides viral load. value Enzyme-Linked Immunosorbent Spot (ELISPOT) assay as a tool recipient's anti-BKV immune response was investigated systematically. Electronic databases, including MEDLINE, Scopus, Cochrane Central Register Controlled Trials were searched studies ELISPOT evaluating against BKV. status categorized "active infection" "resolving infection". Random-effects model meta-analysis performed determine diagnostic performance assay, stratifying patients into groups based on positive negative results. One-hundred twenty-seven articles identified nine included. Patients with had an increased having active replication (odds ratio 71.9 (95%-CI 31.0–167.1). Pooled sensitivity 0.95 0.89–0.98) specificity 0.88 0.78–0.94). standardized mean difference number IFN-γ producing cells between compared who resolving -2.09 -2.50, -1.68). useful assessment combination may support clinicians guiding therapy replication.