First confirmed case of native polyomavirus BK nephropathy in a liver transplant recipient seven years post-transplant.

Renal dysfunction frequently occurs in liver transplant recipients and is associated with increased morbidity and mortality. BK virus is a human polyoma virus that reactivates during immunocompromised states and is a known cause of renal allograft dysfunction in renal transplant recipients. However, BK nephropathy of native kidneys is rare in non-renal transplant recipients. There is no published data linking BK virus and renal dysfunction in liver transplant recipients. We describe the first confirmed case of native polyomavirus BK nephropathy in a liver transplant recipient. BK nephropathy should be considered in the differential diagnosis of new renal failure in liver transplant recipients.

Hypertension and nephritic urine sediment following retroperitoneal lymph node dissection.

Retroperitonela lymph node dissection (RPLND), cisplatin-based chemotherapy, and tumor surveillance has dramatically improved survival of patients with non-seminomatous germ cell tumors. Complications, including renal vascular injuries, have been encountered with post-chemotherapy RPLND. We report on a patient with delayed renovascular hypertension and nephritic sediment following RPLND. A thirty year old man presented with well-controlled hypertension following treatment of a left testicular non-seminomatous germ cell tumor 11 years earlier. Post-orchiectomy investigation revealed retroperitoneal lymphadenopathy which was treated with cispaltin-based chemotherapy. A residual mass was managed surgically and during perihilar dissection, the left renal vein was injured and repaired. Current investigation revealed hypertension and a nephritic urine sediment, both of which resolved with left simple nephrectomy. We believe that inadvertent renal artery injury was responsible for this late complication.