Prospective Monitoring of BK Polyomavirus Infection Early Posttransplantation in Nonrenal Solid Organ Transplant Recipients

Doucette, Karen; Pang, Xiaoli; Jackson, K.; Burton, Ilene; Carbonneau, Michelle; Cockfield, Sandra M.; Preiksaitis, Jutta K.

doi:10.1097/tp.0b013e3181722ead

Cited by 60 publications

(50 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In heart, liver and lung transplant recipients have a 5%-25% incidence of viruria, but viremia is uncommon and PyVAN extremely rare (45,46,(120)(121)(122)(123)(124) (47,48). In most cases, treatment with cidofovir was not effective (48).…”

Section: Screening Of Nonrenal Transplant Recipients For Bkv Replicatmentioning

confidence: 99%

“…At these high rates of urinary BKV replication, sloughing of altered epithelial cells with nuclear inclusions ('decoy cells') appear in urine cytology preparations, and virions can be visualized by negative staining electron microscopy (42)(43)(44). In nonkidney SOT recipients, BKV viruria is thought to result from reactivating the endogenous BKV which only exceptionally progresses to clinical disease (40,(45)(46)(47)(48). In kidney transplant recipients, BKV reactivation most likely results from reactivating BKV in tubular epithelial cells of the donor kidney (49) which is then amplified in the urothelial cell layer (41,42).…”

Section: Primary Infection With Bkv Occurs Mostly Without Specific Symentioning

confidence: 99%

See 1 more Smart Citation

BK Virus in Solid Organ Transplant Recipients

Hirsch

Randhawa

2009

American Journal of Transplantation

202

163

View full text Add to dashboard Cite

Section: Screening Of Nonrenal Transplant Recipients For Bkv Replicatmentioning

confidence: 99%

Section: Primary Infection With Bkv Occurs Mostly Without Specific Symentioning

confidence: 99%

BK Virus in Solid Organ Transplant Recipients

Hirsch

Randhawa

2009

American Journal of Transplantation

202

163

View full text Add to dashboard Cite

“…Reportamos los dos primeros casos diagnosticados en 1 400 trasplantes renales realizados en nuestro centro (1969 a 2012). Constituye patología infrecuente en nuestro medio o tal vez no diagnosticada (12) , probadamente relacionada a determinados esquemas que incluyen drogas inmunosupresoras recientes y/o sobredosis de las mismas (10,(13)(14)(15)(16) . Los regíme-nes actuales de inmunosupresión son más potentes e incrementan el riesgo de infecciones virales oportunistas presentes mayormente dentro del primer año (17) .…”

Section: Discussionunclassified

Nefropatía asociada a poliomavirus BK en trasplante renal

et al. 2016

View full text Add to dashboard Cite

ResumenEl objetivo del presente reporte es dar a conocer los dos primeros casos de nefropatía del injerto asociada a poliomavirus BK (NPBK) ocurridos en el Hospital Edgardo Rebagliati Martins, EsSalud, Lima, Perú. El diagnóstico definitivo de la NPBK se corroboró mediante biopsia renal y estudio de microscopia electrónica. En el caso 1, el deterioro funcional renal no se controló a pesar de reducir la inmunosupresión y añadir drogas antivirales (leflunamide y ciprofloxacina), evolucionando a falla renal y su posterior acceso a retrasplante renal. En el caso 2, la alternativa terapéutica se basó en infusión de inmunoglobulina endovenosa asociada a reducción de la inmunosupresión, resultando en moderada mejora histológica y estabilización de la función renal. En ambos injertos renales hubo concomitantemente NPBK y lesiones histológicas compatibles con rechazo agudo celular pendientes de interpretar. En conclusión, la presencia del poliomavirus BK representa serio problema en el riñón trasplantado. La mejor conducta terapéutica se basa en el diagnóstico precoz y subsecuente reducción de la inmunosupresión. Es imprescindible disponer de metodología apropiada que posibilite un diagnóstico preciso. Se utiliza tamizaje de células señuelo o marcadoras (decoy cells) en orina, reacción de cadena polimerasa (PCR), biopsia renal o la microscopia electrónica como método valioso de ayuda en el diagnóstico etiológico viral. Se considera el retrasplante como opción ante la pérdida del injerto por NPBK (caso 1). Palabras clave. Poliomavirus BK; Nefropatía; Trasplante de riñón; Inmunología. Abstract Two documented cases of BK polyomavirus-associated nephropathy (BKVN) seen at Hospital Edgardo Rebagliati Martins, EsSalud, Lima, Peru are reported. Final BKVN diagnosis was confirmed by renal biopsy and electron microscopy study. Case 1: Renal functional deterioration was not controlled despite reduction of immunosuppression and addition of antiviral drugs (leflunomide and ciprofloxacin), evolving to renal failure and subsequent kidney retransplantation. Case 2: The therapeutical management consisted in intravenous immunoglobulin infusion linked to reduction of immunosuppression; this resulted in modest histological improvement and stabilization of renal function. Both renal grafts concomitantly presented BKVN and histological lesions consistent with acute rejection, pending interpretation. In conclusion presence of BK polyomavirus is a serious problem for transplanted kidneys. The best treatment is based on early diagnosis and subsequent reduction of immunosuppression. It is essential to have an appropriate methodology for precise diagnosis. Early electron microscopy is a valuable method for viral etiologic diagnosis. Retransplantation is considered a treatment option when faced with possible BKVN-related graft loss (Case 1). Keywords. BK polyomavirus; Nephropathy; Kidney transplantation; Immunology.

show abstract

“…İnterferon sadece nakil öncesi kullanılabilir. Yeni geliştirilen ilaçlar (sofosbuvir, sofosbuvir-ledipasvir, daclatasvir-sofosbuvir) nakil sonrası tedavide verilebilir (40)(41)(42)(43).…”

Section: Karaciğer Nakli Sonrası Böbrek Fonksiyon Bozukluğuunclassified

Cirrhosis and Renal Dysfunction

Ayar¹

2016

Turk Neph Dial Transpl

View full text Add to dashboard Cite

ÖzBöbrek fonksiyon bozukluğu, sirozlu hastalarda anlamlı morbiditeye yol açar ve klinik olarak akut böbrek hasarı (AKI), kronik böbrek yetmezliği (KBY), KBY üzerine AKI olarak karşımıza çıkar. Başlıca böbrek fonksiyon bozukluğu nedenleri; prerenal azotemi, intrinsik böbrek hasarı, hepatorenal sendrom ve postrenal hastalıklardır. Tanıda serum kreatinin değeri ve kreatinin klirensi en çok kullanılan yöntemler arasındadır. Tedavide nefrotoksik ajanlardan kaçınılması, albümin infüzyonu, vazokonstrüktör ajanlar, vaptan türevleri ve albümin içeren diyaliz seçenekleri (Prometheus, MARS vb) temel tedavi yaklaşımlarıdır. Karaciğer nakli tüm hepatorenal sendromlu ve ilerlemiş karaciğer hastalığı olanlarda düşünülmelidir. İleri karaciğer yetmezliği geliştikten sonra böbrek yetmezliği üç aydan daha fazla devam edenlerde ve özel endikasyon durumlarında karaciğer ve böbrek nakli birlikte uygulanabilir. Nakil sonrası komplikasyonlar açısından hastaların yakın takibi gerekir. Bu yazıda sirotik hastalarda böbrek fonksiyon bozukluğu ile ilgili güncel bilgiler gözden geçirilmiştir.AnAHtAR sÖzcüklER: Siroz, Akut böbrek hasarı, Kronik böbrek yetmezliği, Hepatorenal sendrom, Tedavi AbstRActRenal dysfunction in patients with cirrhosis causes significant morbidity, and clinically appears as acute kidney injury (AKI), chronic renal failure (CRF), and CRF on AKI. The main causes of renal dysfunction are prerenal azotemia, intrinsic renal failure, hepatorenal syndrome and postrenal disease. Serum creatinine and creatinine clearance are among the most commonly used parameters for the diagnosis. Avoidance of nephrotoxic agents, albumin infusion, vasoconstrictor agents, vaptan derivatives, and dialysis options including albumin are the basic treatment approaches. Liver transplantation should be considered in patients with advanced liver disease and all hepatorenal syndrome cases. After development of advanced liver failure, patients with continuing kidney failure over three months and special indications can be considered for combined liver and kidney transplantations. In this article, we reviewed the current information on kidney dysfunction in cirrhotic patients. kEY woRDs: Cirrhosis, Acute kidney injury, Chronic kidney disease, Hepatorenal syndrome, Treatment GİRİŞ Siroz; değişik nedenlerle oluşan parenkim hasarı, fibrozis ve nodül oluşumu ile birlikte, lobüler ve vasküler yapının bozulması ile karakterize, yaygın ve ilerleyici karaciğer hastalığıdır (1). Böbrek disfonksiyonu, son dönem karaciğer yetmezliği olanlarda sık görülen, mortalite ve morbiditeyi artıran bir komplikasyondur (2,3). Sirotik hastalarda böbrek tutulumunun derecesi morbidite ve mortaliteyi etkilemektedir (4). Biz bu derlememizde karaciğer yetmezliği ile böbrek hasarı ilişkisini, güncel tedavi ve klinik yaklaşımları gözden geçirmeyi amaçladık. PatofizyolojiKaraciğer hastalığına bağlı böbrek işlev bozukluğunda splanknik alanda vazodilatasyon oluşur. Karaciğer hastalığı ilerledikçe,

show abstract

Prospective Monitoring of BK Polyomavirus Infection Early Posttransplantation in Nonrenal Solid Organ Transplant Recipients

Cited by 60 publications

References 21 publications

BK Virus in Solid Organ Transplant Recipients

BK Virus in Solid Organ Transplant Recipients

Nefropatía asociada a poliomavirus BK en trasplante renal

Cirrhosis and Renal Dysfunction

Contact Info

Product

Resources

About