Polyomavirus in Renal Transplantation: A Hot Problem

[en] Polyomavirus BK has emerged as an important complication after kidney transplantation. Although, BK nephropathy develops in only1%to5%of renal transplant recipients, its prognosis when present is very poor. The most accepted risk factor is the level of immunosuppressive treatment, but the serostatus of donor and recipient and the absence of human leukocyte antigen C7 in donor and/or recipient influence the BK virus (BKV) reactivation. The gold standard in diagnosing BKV nephropathy (BKVN) continues to be biopsy with use of immunohistochemistry for large T antigens. Urinary decoy cells and blood BKV DNA polymerase chain reaction are used in the screening, but their positive predictive values are poor. However, their use as predictors of the evolution of BKVN is more valuable. The reduction of immunosuppressive therapy currently represents the first-line treatment for BKVN. Cidofovir and leflunomide can be used when BKVN continues to progress. In the event of graft loss, retransplantation is possible with a low risk of recurrence when the infection is no longer active.

Disciplines :

Immunology & infectious disease
Urology & nephrology

Author, co-author :

Bonvoisin, Catherine ; Centre Hospitalier Universitaire de Liège - CHU > Néphrologie

Weekers, Laurent ; Centre Hospitalier Universitaire de Liège - CHU > Néphrologie

Xhignesse, Patricia ; Centre Hospitalier Universitaire de Liège - CHU > Néphrologie

Grosch, Stéphanie ; Centre Hospitalier Universitaire de Liège - CHU > Néphrologie

Milicevic, Miroslav; Université de Liège - ULiège > Faculté de Médecine

Krzesinski, Jean-Marie ; Université de Liège - ULiège > Département des sciences cliniques > Néphrologie

Language :

English

Title :

Polyomavirus in Renal Transplantation: A Hot Problem

Publication date :

15 April 2008

Journal title :

Transplantation

ISSN :

0041-1337

eISSN :

1534-6080

Publisher :

Lippincott Williams & Wilkins, United States - Maryland

Volume :

Issue :

Pages :

S42-S48

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 19 January 2009

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