The diagnostic and therapeutic dilemma of the co-existence of BK virus nephropathy with acute rejection - an experience from a single Centre and review of the literature

Shanmugham, Sabarinath; Bhadauria, Dharmendra; Agrawal, Vinita; Jain, Manoj; Yaccha, Monika; Kaul, Anupma; Veeranki, Vamsidhar; Meyyappan, Jeyakumar; Prasad, Narayan

doi:10.1016/j.trim.2022.101581

Cited by 4 publications

(3 citation statements)

References 20 publications

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“…In a study by Gras et al [ 15 ], acute rejection was found in 13.8% of patients with BKVN at a median of 16 months after infection compared with 3% of matched controls (P=0.003), with a significantly higher level of donor-specific antibodies (DSA) in the BKVN patients. Other investigators also have noted a higher level of DSA following BKVN, and up to 45% of rejection episodes are antibody-mediated or mixed rejection [ 62 , 95 – 98 ].…”

Section: Differential Diagnosis Of Transplant Rejection and Polyomavi...mentioning

confidence: 99%

Polyomavirus nephropathy: diagnosis, histologic features, and differentiation from acute rejection

Nast

2024

Clin Transplant Res

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Polyomaviruses, particularly BK virus, are ubiquitous latent infections that may reactivate with immunosuppression during kidney transplantation, resulting in polyomavirus nephropathy (PVN). The levels of viruria and viremia serve as tools for screening and making a presumptive diagnosis of PVN, respectively, while a definitive diagnosis requires a kidney biopsy. There are histologic classifications of PVN based on the extent of tubular cell viral infection, interstitial fibrosis, and interstitial inflammation. These classifications correlate to some degree with graft function and loss, aiding in determining treatment efficacy and prognostication. PVN has histologic overlap with acute cell-mediated rejection, making the differential diagnosis challenging, although there are suggestive features for these different causes of graft dysfunction. This article reviews the diagnosis, histologic findings, and classifications of PVN, and discusses how to differentiate viral nephropathy from acute rejection.

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Section: Differential Diagnosis Of Transplant Rejection and Polyomavi...mentioning

confidence: 99%

Polyomavirus nephropathy: diagnosis, histologic features, and differentiation from acute rejection

Nast

2024

Clin Transplant Res

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“…BKV-associated nephritis (BKVAN) is the most frequent clinical reactivation in renal transplant recipients and frequently results in graft rejection [5]. Recent studies have extensively explored the characteristics of BKVAN, along with diagnostic and therapeutic strategies [6][7][8][9][10][11][12][13]. BKVAN occurs in 1.3-4% of all patients who undergo kidney transplantation [14,15].…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Efficiency of the Cobas 6800 System for BK Virus Detection in Plasma and Urine Samples

Song,

Kim,

Kwak

et al. 2023

Diagnostics

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We evaluated the overall performance of the Cobas 6800 BKV test in detecting BK virus (BKV). We examined the imprecision of the Cobas 6800 BKV test and compared the qualitative and quantitative results obtained from the Cobas 6800 BKV test and the Real-Q BKV quantification assay. We assessed 88 plasma and 26 urine samples collected between September and November 2022 from patients with BKV infection using the Real-Q BKV quantitative assay. The lognormal coefficient of variation indicated that the inter-assay precision of the Cobas 6800 BKV test ranged from 13.86 to 33.83%. A strong correlation was observed between the quantitative results obtained using the Cobas 6800 BKV test and the Real-Q BKV quantification assay for plasma samples. The Spearman’s rank correlation coefficients (ρ) for plasma, polymerase chain reaction (PCR) media-stabilized urine, and raw urine samples were 0.939, 0.874, and 0.888, respectively. Our analyses suggest that the Cobas 6800 BKV test is suitable for clinical applications owing to the strong correlation between the results obtained using this test and the Real-Q BKV quantification assay in plasma and urine samples. Furthermore, utilizing fresh raw urine samples can be a viable approach for the Cobas 6800 BKV test as it is less labor- and time-intensive.

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“…In general, protecting graft function, modulating immune rejection, and ameliorating the damage caused by complications are all processes that can interact with each other ( Tammaro et al ; Quaglia et al ; 11 ). Donor injury can induce innate and adaptive immune reactions, while rejection can exacerbate graft damage.…”

mentioning

confidence: 99%

Editorial: Novel mechanisms and approaches in kidney/pancreas-kidney transplant-related injury

et al. 2022

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The diagnostic and therapeutic dilemma of the co-existence of BK virus nephropathy with acute rejection - an experience from a single Centre and review of the literature

Cited by 4 publications

References 20 publications

Polyomavirus nephropathy: diagnosis, histologic features, and differentiation from acute rejection

Polyomavirus nephropathy: diagnosis, histologic features, and differentiation from acute rejection

Evaluating the Efficiency of the Cobas 6800 System for BK Virus Detection in Plasma and Urine Samples

Editorial: Novel mechanisms and approaches in kidney/pancreas-kidney transplant-related injury

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