Abstract
Introduction: BK virus associated allograft nephropathy (BKVAN) is an important cause of allograft lost that often occurs in the first year of transplantation. The state of over immunosuppression also predispose these patients to various opportunistic viral infection Objectives: This research aimed to study the renal transplanted patients for BK viremia and BKVAN. Patients and methods: This observational study was conducted between January 2013 to December 2014 to study the renal transplanted patients for BK viremia and BKVAN. In our center patients received combination of de-sensitization therapy including antithymocyte globulin (ATG), rituximab (RITU), basiliximab, therapeutic plasma exchange, and methylprednisolone (MTP), in high risks or only MTP therapy in immunologically low risk patients. Results: Of total number of 26 patients (20-52 years, M/F 17/9), seven patients received ATG and seven patient received intensive desensitizing protocols, BKVAN and BK viremia happened in three and two patients in above groups subsequently, only one patient developed BKVAN in low risk group. We also observed; cytomegalovirus (CMV) and parvovirus B19 infection and hemophagocytic syndrome (HPS), thrombotic microangiopathy (TMA) and endocarditis in our patients with BKVAN and BK viremia. Conclusion: Awareness about the possibility of BK virus nephropathy and appropriate immunosuppression minimization are crucial components of management. Consideration of other opportunistic infections and specific syndromes are also very important.
Highlights
BK virus associated allograft nephropathy (BKVAN) is an important cause of allograft lost that often occurs in the first year of transplantation
*Corresponding author: Mohammadreza Ardalan, Email; ardalan34@yahoo.com. In this investigation, we aimed to report a group of renal transplant recipient with BK viremia and BKVAN nephropathy in whom we discovered another viral infections and infection related specific syndromes
Majority of cases of BK viremia and BKVN happened in high risk patients who received intensive desensitizing immunosuppressive regiment containing antithymocyte globulin (ATG) (5/6 patients)
Summary
BK virus associated allograft nephropathy (BKVAN) is an important cause of allograft lost that often occurs in the first year of transplantation. The state of over immunosuppression predispose these patients to various opportunistic viral infection Objectives: This research aimed to study the renal transplanted patients for BK viremia and BKVAN. BK virus associated allograft nephropathy (BKVAN) recently has become an important cause of allograft lost, and often occurs in the first year of transplantation [1,2]. The immunosuppressive situation that creates BKVAN is suitable for many other opportunistic infections and pathophysiologic conditions, such as thrombotic microangiopathy (TMA) and activated macrophage syndrome (HPS). All above conditions lead to allograft failure, if not considered and treated appropriately
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