BK Virus Nephropathy in Pediatric Renal Transplant Recipients

Smith, Jodi M.; Dharnidharka, Vikas R.; Talley, Lynya; Martz, Karen; McDonald, Ruth A.

doi:10.2215/cjn.04051206

Cited by 119 publications

(127 citation statements)

References 29 publications

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“…Since the majority of patients (7 of 9) that were treated for acute rejection received depleting antibody therapy, these data further implicate a history of depleting antibody use in BKVAN outcomes. Whether depleting antibody therapy predisposes patients to BKVAN is controversial, as some studies have found a correlation between antilymphocyte preparation use and the development of BKVAN (22,25) and others have not (9,26). It is possible that patients who are given depleting antibody therapy, either for induction or acute rejection, are at higher immunological risk and thus may be exposed to higher levels of chronic immunosuppression, which could bias the outcomes in BKVAN.…”

Section: Discussionmentioning

confidence: 99%

Aggressive Immunosuppression Minimization Reduces Graft Loss Following Diagnosis of BK Virus-Associated Nephropathy

Weiss¹,

Gralla²,

Chan³

et al. 2008

Clinical Journal of the American Society of Nephrology

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Results: Of 910 kidney transplants, 35 (3.8%) cases of BKVAN were diagnosed at a median of 15 months after transplant (range, 5.5 to 90 months after transplant), 16 (46%) of which progressed to graft failure at a median of 11 months (range, 2 to 36 months) after diagnosis. Depleting antibody induction was a significant risk factor for graft loss on univariate analysis, whereas early drug withdrawal (<1 mo following diagnosis) protected against graft loss. On multivariate analysis, these findings were independent predictors of graft outcomes. Additionally, when patients were comanaged by referring nephrologists and the transplant center before the diagnosis of BKVAN, the risk of graft loss was 11-fold higher (P ‫؍‬ 0.03) than if patients were managed solely by the transplant center.Conclusions: Increased awareness and early diagnosis of BKVAN, with aggressive tapering of immunosuppression once established, is critical to preserve kidney graft function. Early drug withdrawal to low-dose two-drug therapy maintenance may be preferable to a general reduction of agents.

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Section: Discussionmentioning

confidence: 99%

Aggressive Immunosuppression Minimization Reduces Graft Loss Following Diagnosis of BK Virus-Associated Nephropathy

Weiss¹,

Gralla²,

Chan³

et al. 2008

Clinical Journal of the American Society of Nephrology

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“…1,19 Mean serum creatinine value observed in BKVAN was higher than the viraemia-viruria group without evidence of nephropathy though the data is small for statistical analysis. Graft dysfunction can be attributed unequivocally to BKV infection in 5% of cases (biopsy proven BKVAN).…”

Section: Bk Polyoma Viral Nephropathymentioning

confidence: 87%

“…[17][18][19] No specific maintenance immunosuppressive agent has been identified but patients who receive tacro-and mmf-based regimens have been found to be at high risk. 19 In our series, patients with BKV infection receiving tacro/ mmf were high but on analysis were not found to be statistically significant. Statistically significant correlation was found between BKV infection and patients receiving ATG for treatment for steroid resistant rejection and as induction therapy.…”

Section: Bk Polyoma Viral Nephropathymentioning

confidence: 99%

BK polyoma viral infection in renal allograft recipients

Badwal

Chopra

Varma³

et al. 2011

Medical Journal Armed Forces India

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“…BKV associated nephropathy affects 1-10% of renal transplant recipients and linked to the strength of the immunosuppression. Higher incidence of BK viremia is related to a higher dose of rabbit ATG [72][73][74][75].…”

Section: Bk Virus (Bkv)mentioning

confidence: 99%

Low Dose Rabbit Anti-Thymocyte Globulin as an Induction immunosuppression in High-Risk Renal Transplant Recipients

Halawa¹

2017

UNOAJ

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High immunologic risk recipients pose a major challenge in transplantation. It is associated with early acute rejection post-transplantation and leads to decrease patient and graft survival. The need for effective immunosuppression early post-transplantation has resulted in emerging of induction protocols. Biologic agents used for induction are classified to monoclonal and polyclonal which are either depletive or non-depletive antibody therapies. Choosing the best agent and optimal dose remains a controversial issue and depends on many factors including the proper assessment of the immunologic risk, efficacy and safety of the used agent. There is no consensus for the optimal agent used as induction immunosuppression in kidney transplantation. rATG use is associated with decreased incidence of delayed graft function and acute rejection episodes.

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BK Virus Nephropathy in Pediatric Renal Transplant Recipients

Cited by 119 publications

References 29 publications

Aggressive Immunosuppression Minimization Reduces Graft Loss Following Diagnosis of BK Virus-Associated Nephropathy

Aggressive Immunosuppression Minimization Reduces Graft Loss Following Diagnosis of BK Virus-Associated Nephropathy

BK polyoma viral infection in renal allograft recipients

Low Dose Rabbit Anti-Thymocyte Globulin as an Induction immunosuppression in High-Risk Renal Transplant Recipients

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