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By Venkatesh Ariyamuthu Transplant Nephrologist at UT Southwestern Medical Center
B J Nankivell, J Renthawa, R N Sharma, K Kable, P J O'Connell, J R Chapman
Reactivation of BK virus in renal allografts causes a destructive chronic infection. This single-center retrospective cohort study describes the evolution of BK virus allograft nephropathy (BKVAN) from 63 kidneys (from 61 patients) using sequential histopathology (454 biopsies, averaging 7.8 ± 2.6 per kidney) followed for 60.1 mo. Uninfected protocol biopsies formulated time-matched control Banff scores (n = 975). Interstitial inflammation occurred in 73% at diagnosis, correlating with viral histopathology (r = 0...
August 2017: American Journal of Transplantation
C S Bicalho, R R Oliveira, L C Pierrotti, M C D S Fink, P R P Urbano, L H S Nali, E J A Luna, C M Romano, D R David, E David-Neto, C S Pannuti
BK virus-(BKV) associated nephropathy (BKVN) is a major cause of allograft injury in kidney transplant recipients. In such patients, subclinical reactivation of latent BKV infection can occur in the pre-transplant period. The purpose of this study was to determine whether urinary BKV shedding in the immediate pre-transplant period is associated with a higher incidence of viruria and viremia during the first year after kidney transplantation. We examined urine samples from 34 kidney transplant recipients, using real-time quantitative polymerase chain reaction to detect BKV...
July 2016: Clinical Transplantation
Thomas Jouve, Lionel Rostaing, Paolo Malvezzi
CONTEXT: BK virus (BKV) viremia and BKV-associated nephropathy (BKVAN) have become a serious nuisance to kidney transplant (KT) patients since the mid-nineties, when the incidence of this disease has increased significantly. EVIDENCE ACQUISITION: Directory of open access journals (DOAJ), EMBASE, Google Scholar, PubMed, EBSCO, and Web of Science have been searched. RESULTS: Many hypothesis have been made as to why this phenomenon has developed; it is of general opinion that a more potent immunosuppression is at the core of the problem...
January 2016: Journal of Nephropathology
Miroslav Sekulic, Gretchen S Crary, Loren P Herrera Hernandez
Polyomavirus nephropathy is characterized histopathologically by evidence of viral replication and acute tubular injury with interstitial inflammation, tubulitis, and intranuclear inclusions. Polyomavirus nephropathy typically develops in the kidney transplant as a combination of the unique nature of the transplanted tissue and the immunomodulated status of the patient. We present a case in which a patient had lingering BK viremia and declining kidney function following receipt of lung and kidney transplants...
August 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Stephanie M McGregor, W James Chon, Lisa Kim, Anthony Chang, Shane M Meehan
AIM: To describe the clinicopathologic features of concurrent polyomavirus nephropathy (PVN) and endarteritis due to rejection in renal allografts. METHODS: We searched our electronic records database for cases with transplant kidney biopsies demonstrating features of both PVN and acute rejection (AR). PVN was defined by the presence of typical viral cytopathic effect on routine sections and positive polyomavirus SV40 large-T antigen immunohistochemistry. AR was identified by endarteritis (v1 by Banff criteria)...
December 24, 2015: World Journal of Transplantation
Anke Schwarz, Silvia Linnenweber-Held, Albert Heim, Theodor Framke, Hermann Haller, Corinna Schmitt
BACKGROUND: BK virus (BKV) nephropathy remains the main cause of renal graft loss after living-donor renal transplantation. The aim of the study was to investigate the source and factors influencing the course of BKV infection. METHODS: We investigated 214 living donor-recipient pairs. Urine and blood of donors and recipients were tested by qPCR for the presence of BKV DNA before and after transplantation; genotyping of BKV subtypes was performed. RESULTS: Eighty-five recipients (40%) had posttransplant BK viruria including 61 with additional viremia and 22 with nephropathy...
April 2016: Transplantation
Benjamin J D Weist, Patrizia Wehler, Linda El Ahmad, Michael Schmueck-Henneresse, Jason M Millward, Mikalai Nienen, Avidan U Neumann, Petra Reinke, Nina Babel
Reactivation of Polyomavirus BKV is a severe complication in kidney transplant patients. Current treatment requires close monitoring, and modification of immunosuppressive drugs. As an important additional tool, the monitoring of BKV immunity has been based on detection of cytokine-secreting T cells upon BKV-antigen challenge. However, low frequent BKV-specific T cells are often barely detectable and their roles in BKV clearance remain unclear. Here, we analyzed the effects of immunosuppressive agents on BKV-specific T cells in vitro...
December 2015: Kidney International
Dirk R J Kuypers
Polyomavirus-associated nephropathy (PVAN) remains an important infectious complication after renal transplantation, affecting 1-10% of recipients and causing graft loss in approximately 50% of cases. With the lack of effective antiviral therapy, intensive monitoring for BK virus (BKV) using nucleic acid testing or urine cytology--in combination with a reduction of immunosuppressive therapy--is advocated to detect and prevent BKV reactivation and PVAN, respectively. In this Review, new insights into BKV biology and the development of PVAN are discussed...
April 17, 2012: Nature Reviews. Nephrology
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