Clinical observation of BK viremia and BK virus-associated nephropathy with rescuing therapy in renaltransplant recipients / 中华器官移植杂志

ABSTRACT

Objective To investigate the clinical efficacy of BK viremia and BK virus-associated nephropathy (BKVAN) with rescuing therapy in renal-transplant recipients.Methods We systematically screened for active BKV infection at 0.5,1,3,6,9,12 and 15 months after transplantation in 116 renal transplant recipients.The screening tests included BKV DNA PCR (the kit for testing the BK virus) assay of both urine and plasma,and the results were recorded.Renal biopsy was performed if the graft function deteriorated gradually or the loads of BKV replication were very high.According to the existing literature material,preferential therapy was given to the patients with BK viremia and BKVAN after renal transplantation.Results Throughout the follow-up of 15 months,urine BKV viruria (median 2.63 × 105 copies/mL,1.78 × 103 8.54 × 109 copies/mL),blood BKV viremia (median 2.70 × 104 copies/mL,1.95 × 103-6.31 × 106 copies/mL),and BKVAN (4 patients) occurred in 24.17％,20.72％ and 3.45％ renal-transplant recipients,respectively.According to related literature and guide,in 24 cases of BKV viremia including 4 BKVAN patients,the dosages of immunosuppressants were reduced or FK506 was replaced with CsA,the disease conditions were effectively improved,and no acute rejection,allograft dysfunction or graft loss occurred.Conclusion Rescuing therapy of immunosuppression reduction or replacing FK506 with CsA was effective for BKV viremia and BKVAN recipients,and could not increase the risk of acute rejection and graft loss.