The BK virus in renal transplant recipients-review of pathogenesis, diagnosis, and treatment

Vikas R. Dharnidharka, Husam A. Abdulnour, Carlos E. Araya

Research output: Contribution to journalReview articlepeer-review

43 Scopus citations

Abstract

The BK virus, a DNA virus from the Polyomavirus group, represents an opportunistic infection of immunosuppressed transplant recipients. Though the virus was discovered approximately 40 years ago, the emergence of BK virus nephropathy since 1995 onwards, with associated high graft loss rates, has revolutionized renal transplantation medicine. Kidney transplant professionals realized that the consequences of over-immunosuppression were as severe as the consequences of under-immunosuppression and we entered the era of immunosuppressive minimization. Despite this recognition, the optimal testing type for BK virus infections and frequency of testing are hotly debated. Similarly, optimal treatment strategies remain sources of intense controversy. The authors review the current strategies of screening, diagnosis, and possible treatment, and also review the amount and quality of evidence in favor or against. Similarities and differences between cytomegalovirus, Epstein-Barr virus, and BV virus, the three major viral infections in kidney transplantation, are highlighted.

Original languageEnglish
Pages (from-to)1763-1774
Number of pages12
JournalPediatric Nephrology
Volume26
Issue number10
DOIs
StatePublished - Oct 1 2011

Keywords

  • BK Virus
  • BK virus allograft nephropathy
  • Children
  • Cidofovir
  • Kidney transplant
  • Leflunomide
  • PCR testing
  • Polyoma virus

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