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https://www.readbyqxmd.com/read/28512328/tacrolimus-blood-level-fluctuation-predisposes-to-coexisting-bk-virus-nephropathy-and-acute-allograft-rejection
#1
Chia-Lin Shen, An-Hang Yang, Tse-Jen Lien, Der-Cherng Tarng, Chih-Yu Yang
BK virus nephropathy (BKVN) and allograft rejection are two distinct disease entities which occur at opposite ends of the immune spectrum. However, they coexist in renal transplant recipients. Predisposing factors for this coexistence remain elusive. We identified nine biopsy-proven BKVN patients with coexisting acute rejection, and 21 patients with BKVN alone. We retrospectively analyzed the dosage and blood concentrations of immunosuppressants during the 3-month period prior to the renal biopsy between the two patient groups...
May 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28510315/bk-virus-nephropathy-revisited
#2
EDITORIAL
M Mengel
No abstract text is available yet for this article.
May 16, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28492728/evaluation-of-the-predisposition-and-clinical-impact-of-bk-virus-replication-in-kidney-transplant-patients
#3
Elviani B Moura, Silvia V Petzhold, Augusto R Amaral, Luciane M Deboni, Paulo H C DE França
The BK virus (BKV) produces a subclinical kidney infection in immunocompetent individuals. However, viremia may occur in kidney transplant patients with ongoing immunosuppression. BKV-associated nephropathy (BKVN) has no specific treatment and is a leading cause of organ transplant loss. In this study, we evaluated the predisposition and the clinical impact of BKV replication in kidney transplant patients during post-transplant monitoring in a reference institution in Brazil. Demographic, clinical and laboratory data generated during routine outpatient follow-up were retrospectively collected...
May 2017: Anais da Academia Brasileira de Ciências
https://www.readbyqxmd.com/read/28457399/polyomavirus-nephropathy-ten-year-experience
#4
J S Costa, E Ferreira, R Leal, N Bota, C Romãozinho, V Sousa, C Marinho, L Santos, F Macário, R Alves, J Pratas, M Campos, A Figueiredo
BACKGROUND: Polyomavirus nephropathy (BKVN) is an important cause of chronic allograft dysfunction (CAD). Recipient determinants (male sex, white race, and older age), deceased donation, high-dose immunosuppression, diabetes, delayed graft function (DGF), cytomegalovirus infection, and acute rejection (AR) are risk factors. Reducing immunosuppression is the best strategy in BKVN. The objective of our study was to evaluate CAD progression after therapeutic strategies in BKVN and risk factors for graft loss (GL)...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/27872831/outcomes-of-renal-transplant-recipients-with-bk-virus-infection-and-bk-virus-surveillance-in-the-auckland-region-from-2006-to-2012
#5
Chun-Yuan Hsiao, Helen L Pilmore, Lifeng Zhou, Janak R de Zoysa
AIM: To evaluate incidence, risk factors and treatment outcome of BK polyomavirus nephropathy (BKVN) in a cohort of renal transplant recipients in the Auckland region without a formal BK polyomavirus (BKV) surveillance programme. METHODS: A cohort of 226 patients who received their renal transplants from 2006 to 2012 was retrospectively reviewed. RESULTS: Seventy-six recipients (33.6%) had a BK viral load (BKVL) test and 9 patients (3.9%) developed BKVN...
November 6, 2016: World Journal of Nephrology
https://www.readbyqxmd.com/read/27762478/bk-polyomavirus-infection-in-pediatric-heart-transplant-recipients-a-prospective-study
#6
Allison Ducharme-Smith, Ben Z Katz, Amy E Bobrowski, Carl L Backer, Elfriede Pahl
BKV infection and nephropathy complicate pediatric HTx, but the incidence and time course of the disease are unknown. We assessed the incidence of BKV infection and its association with kidney dysfunction in pediatric HTx recipients. A single center prospective study compared pediatric (<18 years) HTx recipients, with and without BKV infection, who received an allograft between September 2013 and December 2014. Screening of urine for BKV was performed prior to transplant, and at week 1, and at months 3, 6, 9, 12, and 15 months post-transplantation...
March 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/27723787/clinically-relevant-reactivation-of-polyomavirus-bk-bkpyv-in-hla-a02-positive-renal-transplant-recipients-is-associated-with-impaired-effector-memory-differentiation-of-bkpyv-specific-cd8-t-cells
#7
Michiel C van Aalderen, Ester B M Remmerswaal, Kirstin M Heutinck, Anja Ten Brinke, Mariet C W Feltkamp, Neelke C van der Weerd, Karlijn A M I van der Pant, Frederike J Bemelman, René A W van Lier, Ineke J M Ten Berge
Polyomavirus BK (BKPyV) frequently reactivates in immunosuppressed renal transplant recipients (RTRs) and may lead to graft loss due to BKPyV-induced interstitial nephritis (BKVN). Little is known on the differentiation of CD8+ T cells targeting BKPyV in RTRs. Here we investigated whether BKPyV-specific CD8+ T cell differentiation differs in RTRs with varying degrees of BKPyV reactivation and/or BKVN. Using combinatorial encoding with tetramers carrying BKPyV major capsid protein (VP1) and large T antigen protein (LTAG) epitopes, we investigated CD8+ T cell responses to BKPyV in longitudinally obtained PBMC samples from 46 HLA-A02-positive RTRs and 20 healthy adults...
October 2016: PLoS Pathogens
https://www.readbyqxmd.com/read/27668162/high-level-viruria-as-a-screening-tool-for-bk-virus-nephropathy-in-renal-transplant-recipients
#8
W James Chon, Nidhi Aggarwal, Masha Kocherginsky, Brenna Kane, Jozefa Sutor, Michelle A Josephson
BACKGROUND: Although early monitoring of BK virus infection in renal transplant patients has led to improved outcomes over the past decade, it remains unclear whether monitoring for viremia is the best screening tool for BK virus nephropathy (BKVN). METHODS: We conducted a retrospective review of the medical records of 368 renal transplant recipients who had a minimum of 18 months of posttransplantation follow-up. The relationship between the presence of BK viruria and a composite end point of BK viremia/BKVN was established, and the predictive value of high-grade BK viruria for development of viremia/BKVN was determined...
September 2016: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/27639176/incidence-of-bk-polyomavirus-infection-after-kidney-transplantation-is-independent-of-type-of-immunosuppressive-therapy
#9
Josephine Radtke, Nina Dietze, Lutz Fischer, Eike-Gert Achilles, Jun Li, Silke Scheidat, Friedrich Thaiss, Bjoern Nashan, Martina Koch
BACKGROUND: BK polyomavirus (BKV) infection and BKV nephropathy (BKVN) are risk factors for allograft function and survival. METHODS: We retrospectively analyzed BK viremia and BKVN in 348 patients who received a kidney transplantation donated after brain death (n=232) or living donation (n=116) between 2008 and 2013. A total of 266 patients were treated with standard immunosuppression consisting of basiliximab induction, calcineurin inhibitor (CNI), and mycophenolic acid (MPA, n=219) or everolimus (n=47); 82 patients received more intense immunosuppression with lymphocyte depletion, CNI and MPA (n=38) or everolimus (n=44)...
December 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27633952/a-diverse-virome-in-kidney-transplant-patients-contains-multiple-viral-subtypes-with-distinct-polymorphisms
#10
Asha Rani, Ravi Ranjan, Halvor S McGee, Ahmed Metwally, Zahraa Hajjiri, Daniel C Brennan, Patricia W Finn, David L Perkins
Recent studies have established that the human urine contains a complex microbiome, including a virome about which little is known. Following immunosuppression in kidney transplant patients, BK polyomavirus (BKV) has been shown to induce nephropathy (BKVN), decreasing graft survival. In this study we investigated the urine virome profile of BKV+ and BKV- kidney transplant recipients. Virus-like particles were stained to confirm the presence of VLP in the urine samples. Metagenomic DNA was purified, and the virome profile was analyzed using metagenomic shotgun sequencing...
September 16, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27573493/influence-of-tacrolimus-metabolism-rate-on-bkv-infection-after-kidney-transplantation
#11
Gerold Thölking, Christina Schmidt, Raphael Koch, Katharina Schuette-Nuetgen, Dirk Pabst, Heiner Wolters, Iyad Kabar, Anna Hüsing, Hermann Pavenstädt, Stefan Reuter, Barbara Suwelack
Immunosuppression is the major risk factor for BK virus nephropathy (BKVN) after renal transplantation (RTx). As the individual tacrolimus (Tac) metabolism rate correlates with Tac side effects, we hypothesized that Tac metabolism might also influence the BKV infection risk. In this case-control study RTx patients with BK viremia within 4 years after RTx (BKV group) were compared with a BKV negative control group. The Tac metabolism rate expressed as the blood concentration normalized by the daily dose (C/D ratio) was applied to assess the Tac metabolism rate...
2016: Scientific Reports
https://www.readbyqxmd.com/read/27500256/a-preliminary-study-into-the-significance-of-intrarenal-reflux-in-bk-virus-nephropathy-after-kidney-transplantation
#12
Kunio Kawanishi, Kazuho Honda, Junki Koike, Motoshi Hattori, Shouhei Fuchinoue, Kazunari Tanabe, Hideaki Oda, Yoji Nagashima
BACKGROUND: The BK virus typically colonizes the lower urinary tract and is the causative agent in BK virus nephropathy (BKVN), which can progress to allograft dysfunction and graft loss. Urinary reflux in kidney allografts is induced by vesicoureteral reflux or disturbances in intrarenal reflux (IRR), believed to be associated with BKVN. This study was designed to elucidate the relationship between BKVN and IRR. METHODS: We examined 30 renal transplant recipients histologically diagnosed with BKVN using anti-Simian virus 40 immunohistochemistry and 60 clinically matched control recipients...
February 2016: Transplantation Direct
https://www.readbyqxmd.com/read/27448566/optimal-use-of-plasma-and-urine-bk-viral-loads-for-screening-and-predicting-bk-nephropathy
#13
Peter Boan, Christopher Hewison, Ramyasuda Swaminathan, Ashley Irish, Kevin Warr, Rajalingam Sinniah, Todd M Pryce, James Flexman
BACKGROUND: BK virus is a polyoma virus causing renal allograft nephropathy. Reduction of immunosuppression with the early recognition of significant BK viral loads in urine and plasma can effectively prevent BKV associated nephropathy (BKVN), however the optimal compartment and frequency of BK viral load measurement post renal transplantation are undetermined. Our purpose was to examine time to detection and viral loads in urine compared to plasma, and establish viral load cut-offs associated with histological BKVN...
July 22, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27411570/bk-virus-encephalopathy-and-sclerosing-vasculopathy-in-a-patient-with-hypohidrotic-ectodermal-dysplasia-and-immunodeficiency
#14
Armine Darbinyan, Eugene O Major, Susan Morgello, Steven Holland, Caroline Ryschkewitsch, Maria Chiara Monaco, Thomas P Naidich, Joshua Bederson, Joanna Malaczynska, Fei Ye, Ronald Gordon, Charlotte Cunningham-Rundles, Mary Fowkes, Nadejda M Tsankova
Human BK polyomavirus (BKV) is reactivated under conditions of immunosuppression leading most commonly to nephropathy or cystitis; its tropism for the brain is rare and poorly understood. We present a unique case of BKV-associated encephalopathy in a man with hypohidrotic ectodermal dysplasia and immunodeficiency (HED-ID) due to IKK-gamma (NEMO) mutation, who developed progressive neurological symptoms. Brain biopsy demonstrated polyomavirus infection of gray and white matter, with predominant involvement of cortex and distinct neuronal tropism, in addition to limited demyelination and oligodendroglial inclusions...
2016: Acta Neuropathologica Communications
https://www.readbyqxmd.com/read/27234769/how-to-improve-the-positive-predictive-value-of-urinary-decoy-cell-surveillance-for-polyomavirus-bk-associated-nephropathy-in-kidney-transplant-patients
#15
T-W Chen, C-Y Chen, N-C Lin, K-L King, T-H Wu, W-C Yang, C-C Loong
BACKGROUND: Polyomavirus BK-associated nephropathy (BKVN) has been a serious problem after kidney transplantation. Detection of urinary decoy cells (UDCs) and assessment of polyomavirus BK nucleic acids by polymerase chain reactions (PCRs) are currently used, noninvasive tests. PCRs have better positive predictive value (PPV) but higher cost and lower accessibility. This study investigated ways to improve the PPV of UDCs for BKVN prediction. METHODS: From 2000 to 2013, kidney transplant recipients with sustained UDCs for more than half a month and who had received allograft biopsies were enrolled...
April 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27106006/fluoroquinolone-prophylaxis-in-preventing-bk-polyomavirus-infection-after-renal-transplant-a%C3%A2-systematic-review-and-meta-analysis
#16
REVIEW
Tu-Run Song, Zheng-Sheng Rao, Yang Qiu, Jin-Peng Liu, Zhong-Li Huang, Xian-Ding Wang, Tao Lin
Previous studies regarding the prevention of BK viremia following renal transplantation with fluoroquinolone have yielded conflicting results. The purpose of this systematic review was to examine the evidence regarding the efficacy of fluoroquinolone in preventing BK polyomavirus infection following renal transplantation. We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials for research articles published prior to January 2015 using keywords such as "fluoroquinolone," "BK viremia," and "renal transplantation...
March 2016: Kaohsiung Journal of Medical Sciences
https://www.readbyqxmd.com/read/27101526/pre-transplant-shedding-of-bk-virus-in-urine-is-unrelated-to-post-transplant-viruria-and-viremia-in-kidney-transplant-recipients
#17
C S Bicalho, R R Oliveira, L C Pierrotti, M C D S Fink, P R P Urbano, L H S Nali, E J A Luna, C M Romano, D R David, E David-Neto, C S Pannuti
BK virus-(BKV) associated nephropathy (BKVN) is a major cause of allograft injury in kidney transplant recipients. In such patients, subclinical reactivation of latent BKV infection can occur in the pre-transplant period. The purpose of this study was to determine whether urinary BKV shedding in the immediate pre-transplant period is associated with a higher incidence of viruria and viremia during the first year after kidney transplantation. We examined urine samples from 34 kidney transplant recipients, using real-time quantitative polymerase chain reaction to detect BKV...
July 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/26998753/in-kidney-transplant-recipients-with-bk-polyomavirus-infection-early-bk-nephropathy-microvascular-inflammation-and-serum-creatinine-are-risk-factors-for-graft-loss
#18
M Mohamed, S Parajuli, B Muth, B C Astor, S E Panzer, D Mandelbrot, W Zhong, A Djamali
BACKGROUND: Little information is available on the risk factors for graft loss in kidney transplant recipients with BK polyomavirus (BKPyV) nephropathy (BKVN) in the presence or absence of antibody-mediated rejection (AMR). METHODS: We examined the risk factors for graft loss in consecutive kidney allograft recipients with biopsy-confirmed BKVN, with or without concomitant AMR. RESULTS: A total of 1904 kidney transplants were performed at our institution during 2005-2011...
June 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/26970406/successful-treatment-with-foscarnet-for-ganciclovir-resistant-cytomegalovirus-infection-in-a-kidney-transplant-recipient-a-case-report
#19
Daiki Iwami, Yayoi Ogawa, Hiromi Fujita, Ken Morita, Hajime Sasaki, Yuichiro Oishi, Haruka Higuchi, Kanako Hatanaka, Nobuo Shinohara
Cytomegalovirus (CMV) infection is the most common infectious complication following solid organ transplantation. Ganciclovir (GCV)-resistant CMV infection may be fatal, and is difficult to treat while avoiding allograft rejection. A 31-year-old woman received a second ABO-incompatible kidney transplant, from her father. Induction therapy consisted of basiliximab and rituximab followed by maintenance immunosuppression with tacrolimus, mycophenolate mofetil, and methylprednisolone. Her CMV serostatus was D(+) /R(-) at second transplant and she received prophylactic low-dose valganciclovir (VGCV)...
July 2016: Nephrology
https://www.readbyqxmd.com/read/26867385/biopsy-proven-bk-virus-nephropathy-without-detectable-bk-viremia-in-a-one-year-post-kidney-transplant-recipient
#20
Prajej Ruangkanchanasetr, Norawee Pumchandh, Bancha Satirapoj, Sumeth Termmathurapoj, Viroj Pongthanapisith
BK virus nephropathy (BKVN) is an important clinical problem in kidney transplant (KT) recipients. The sequence of disease is usually viruria, viremia and then nephropathy. Diagnosis of BK virus (BKV) infection includes checking BKV DNA in the urine, in the plasma and histology on renal biopsy. This last method is used to diagnose BKVN. We describe a KT patient with BKVN without detectable BK viremia. A 62-year-old female with hypertensive nephropathy underwent renal transplant from a living relative donor in December 2011...
July 2015: Southeast Asian Journal of Tropical Medicine and Public Health
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