Biomedical papers - Ahead of Print

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. X:X | 10.5507/bp.2018.018

BK virus-induced renal allograft nephropathy

Karel Krejcia, Tomas Tichyb, Jana Bednarikovac, Kamil Zambocha, Josef Zadrazila
a Department of Internal Medicine III - Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech Republic
b Institute of Molecular and Translational Medicine, University Hospital Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech Republic
c Department of Clinical Biochemistry, University Hospital Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech Republic

BK virus nephropathy (BKVN) is a serious opportunistic infection threatening renal function especially during the first year after transplantation. Its incidence is now on the rise and is closely related to the level of the recipient's immune system inhibition. This is more intensive with current trends in transplantation medicine, where more potent immunosuppressive protocols are used and more aggressive antirejection therapy is applied. In the absence of BK virus (BKV) specific therapy and limited treatment options for advanced BKVN, active screening of BKV replication and subsequent preemptive adjustment of immunosuppression are essential measures to prevent BKVN. However, it remains unclear how to modify immunosuppressive protocols as well as how to address initial stages of BKV replication. This comprehensive review summarizes the currently applied and not completely uniform procedures for the detection, prophylaxis and therapy of BKV replication and BKVN. The pitfalls brought by reduced immunosuppression, as a typical response to a significant viral replication or a developed BKVN, are also mentioned, particularly in the form of graft rejection. The paper also outlines the authors' experiences, and lists currently ongoing studies on the subject. The perspectives of new, especially immune-based, procedures in the treatment of complications associated with BKV infections are highlighted. Different views on the management of patients indicated for kidney re-transplantation whose previous graft failed because of BKVN are also discussed.

Keywords: kidney transplantation, immunosuppressive therapy, BK virus immunotherapy, BK graft nephropathy, kidney biopsy, preemptive therapy

Received: December 12, 2017; Accepted: April 11, 2018; Prepublished online: May 16, 2018


References

  1. Hariharan S. BK virus nephritis after renal transplantation. Kidney Int 2006;69(4):655-62. Go to PubMed...
  2. Hirsch HH, Knowles W, Dickenmann M, Passweg J, Klimkait T, Mihatsch MJ, Steiger J. Prospective study of polyomavirus type BK replication and nephropathy in renal-transplant recipients. N Engl J Med 2002;347(7):488-96. Go to PubMed...
  3. Ambalathingal GR, Francis RS, Smyth MJ, Smith C, Khanna R. BK Polyomavirus: Clinical Aspects, Immune Regulation, and Emerging Therapies. Clin Microbiol Rev 2017;30(2):503-28.
  4. Purighalla R, Shapiro R, McCauley J, Randhawa P. BK virus infection in a kidney allograft diagnosed by needle biopsy. Am J Kidney Dis 1995;26(4):671-3. Go to PubMed...
  5. Zhong S, Randhawa PS, Ikegaya H, Chen Q, Zheng HY, Suzuki M, Takeuchi T, Shibuya A, Kitamura T, Yogo Y. Distribution patterns of BK polyomavirus (BKV) subtypes and subgroups in American, European and Asian populations suggest co-migration of BKV and the human race. J Gen Virol 2009;90(Pt 1):144-52. Go to PubMed...
  6. Boldorini R, Allegrini S, Miglio U, Nestasio I, Paganotti A, Veggiani C, Monga G, Pietropaolo V. BK virus sequences in specimens from aborted fetuses. J Med Virol 2010;82(12):2127-32. Go to PubMed...
  7. Pastrana DV, Ray U, Magaldi TG, Schowalter RM, Çuburu N, Buck CB. BK polyomavirus genotypes represent distinct serotypes with distinct entry tropism. J Virol 2013;87(18):10105-13. Go to PubMed...
  8. Lamarche C, Orio J, Collette S, Senécal L, Hébert MJ, Renoult É, Tibbles LA, Delisle JS. BK Polyomavirus and the Transplanted Kidney: Immunopathology and Therapeutic Approaches. Transplantation 2016;100(11):2276-87. Go to PubMed...
  9. Hirsch HH, Brennan DC, Drachenberg CB, Ginevri F, Gordon J, Limaye AP, Mihatsch MJ, Nickeleit V, Ramos E, Randhawa P, Shapiro R, Steiger J, Suthanthiran M, Trofe J. Polyomavirus-associated nephropathy in renal transplantation: interdisciplinary analyses and recommendations. Transplantation 2005;79(10):1277-86. Go to PubMed...
  10. Nickeleit V, Hirsch HH, Zeiler M, Gudat F, Prince O, Thiel G, Mihatsch MJ. BK-virus nephropathy in renal transplants-tubular necrosis, MHC-class II expression and rejection in a puzzling game. Nephrol Dial Transplant 2000;15(3):324-32. Go to PubMed...
  11. Egli A, Binggeli S, Bodaghi S, Dumoulin A, Funk GA, Khanna N, Leuenberger D, Gosert R, Hirsch HH. Cytomegalovirus and polyomavirus BK posttransplant. Nephrol Dial Transplant 2007;22 (Suppl 8):viii72-viii82.
  12. Cheng XS, Bohl DL, Storch GA, Ryschkewitsch C, Gaudreault-Keener M, Major EO, Randhawa P, Hardinger KL, Brennan DC. Inhibitory interactions between BK and JC virus among kidney transplant recipients. J Am Soc Nephrol 2011;22(5):825-31. Go to PubMed...
  13. Bohl DL, Storch GA, Ryschkewitsch C, Gaudreault-Keener M, Schnitzler MA, Major EO, Brennan DC. Donor origin of BK virus in renal transplantation and role of HLA C7 in susceptibility to sustained BK viremia. Am J Transplant 2005;5(9):2213-21. Go to PubMed...
  14. Ribeiro A, Wörnle M, Motamedi N, Anders HJ, Gröne EF, Nitschko H, Kurktschiev P, Debiec H, Kretzler M, Cohen CD, Gröne HJ, Schlöndorff D, Schmid H. Activation of innate immune defense mechanisms contributes to polyomavirus BK-associated nephropathy. Kidney Int 2012;81(1):100-11. Go to PubMed...
  15. Comoli P, Cioni M, Basso S, Gagliardone C, Potenza L, Verrina E, Luppi M, Zecca M, Ghiggeri GM, Ginevri F. Immunity to Polyomavirus BK Infection: Immune Monitoring to Regulate the Balance between Risk of BKV Nephropathy and Induction of Alloimmunity. Clin Dev Immunol 2013;2013:256923. Go to PubMed...
  16. Leboeuf C, Wilk S, Achermann R, Binet I, Golshayan D, Hadaya K, Hirzel C, Hoffmann M, Huynh-Do U, Koller MT, Manuel O, Mueller NJ, Mueller TF, Schaub S, van Delden C, Weissbach FH, Hirsch HH. Swiss Transplant Cohort Study. BK Polyomavirus-Specific 9mer CD8 T Cell Responses Correlate With Clearance of BK Viremia in Kidney Transplant Recipients: First Report From the Swiss Transplant Cohort Study. Am J Transplant 2017;17(10):2591-600. Go to PubMed...
  17. Weist BJ, Wehler P, El Ahmad L, Schmueck-Henneresse M, Millward JM, Nienen M, Neumann AU, Reinke P, Babel N. A revised strategy for monitoring BKV-specific cellular immunity in kidney transplant patients. Kidney Int 2015;88(6):1293-303. Go to PubMed...
  18. DeWolfe D, Gandhi J, Mackenzie MR, Broge TA Jr, Bord E, Babwah A, Mandelbrot DA, Pavlakis M, Cardarelli F, Viscidi R, Chandraker A, Tan CS. Pre-transplant immune factors may be associated with BK polyomavirus reactivation in kidney transplant recipients. PLoS One 2017;12(5):e0177339. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28562595 Go to PubMed...
  19. Jamboti JS. BK virus nephropathy in renal transplant recipients. Nephrology (Carlton). 2016;21(8):647-54. Go to PubMed...
  20. 3C Study Collaborative Group, Haynes R, Harden P, Judge P, Blackwell L, Emberson J, Landray MJ, Baigent C, Friend PJ. Alemtuzumab-based induction treatment versus basiliximab-based induction treatment in kidney transplantation (the 3C Study): a randomised trial. Lancet 2014;384(9955):1684-90. Go to PubMed...
  21. Pai D, Mann DM, Malik A, Hoover DR, Fyfe B, Mann RA. Risk Factors for the Development of BK Virus Nephropathy in Renal Transplant Recipients. Transplant Proc 2015;47(8):2465-9. Go to PubMed...
  22. Hirsch HH, Vincenti F, Friman S, Tuncer M, Citterio F, Wiecek A, Scheuermann EH, Klinger M, Russ G, Pescovitz MD, Prestele H. Polyomavirus BK replication in de novo kidney transplant patients receiving tacrolimus or cyclosporine: a prospective, randomized, multicenter study. Am J Transplant 2013;13(1):136-45. Go to PubMed...
  23. Brennan DC, Agha I, Bohl DL, Schnitzler MA, Hardinger KL, Lockwood M, Torrence S, Schuessler R, Roby T, Gaudreault-Keener M, Storch GA. Incidence of BK with tacrolimus versus cyclosporine and impact of preemptive immunosuppression reduction. Am J Transplant 2005;5(3):582-94. Go to PubMed...
  24. van Doesum WB, Gard L, Bemelman FJ, de Fijter JW, Homan van der Heide JJ, Niesters HG, van Son WJ, Stegeman CA, Groen H, Riezebos-Brilman A, Sanders JS. Incidence and outcome of BK polyomavirus infection in a multicenter randomized controlled trial with renal transplant patients receiving cyclosporine-, mycophenolate sodium-, or everolimus-based low-dose immunosuppressive therapy. Transpl Infect Dis 2017 Jun;19(3).[Epub ahead of print] doi:10.1111/tid.12687 Go to original source... Go to PubMed...
  25. Hirsch HH, Yakhontova K, Lu M, Manzetti J. BK Polyomavirus Replication in Renal Tubular Epithelial Cells Is Inhibited by Sirolimus, but Activated by Tacrolimus Through a Pathway Involving FKBP-12. Am J Transplant 2016;16(3):821-32. Go to PubMed...
  26. Moscarelli L, Caroti L, Antognoli G, Zanazzi M, Di Maria L, Carta P, Minetti E. Everolimus leads to a lower risk of BKV viremia than mycophenolic acid in de novo renal transplantation patients: a single-center experience. Clin Transplant 2013;27(4):546-54. Go to PubMed...
  27. Shen CL, Yang AH, Lien TJ, Tarng DC, Yang CY. Tacrolimus Blood Level Fluctuation Predisposes to Coexisting BK Virus Nephropathy and Acute Allograft Rejection. Sci Rep 2017;7(1):1986.[Epub ahead of print] doi:10.1038/s41598-017-02140-1 Go to original source... Go to PubMed...
  28. Wunderink HF, van der Meijden E, van der Blij-de Brouwer CS, Mallat MJ, Haasnoot GW, van Zwet EW, Claas EC, de Fijter JW, Kroes AC, Arnold F, Touzé A, Claas FH, Rotmans JI, Feltkamp MC. Pretransplantation Donor-Recipient Pair Seroreactivity Against BK Polyomavirus Predicts Viremia and Nephropathy After Kidney Transplantation. Am J Transplant 2017;17(1):161-172. Go to PubMed...
  29. Abend JR, Changala M, Sathe A, Casey F, Kistler A, Chandran S, Howard A, Wojciechowski D. Correlation of BK Virus Neutralizing Serostatus With the Incidence of BK Viremia in Kidney Transplant Recipients. Transplantation 2017;101(6):1495-505. Go to PubMed...
  30. Verghese PS, Schmeling DO, Filtz EA, Matas AJ, Balfour HH Jr. The impact of recipient BKV shedding before transplant on BKV viruria, DNAemia, and nephropathy post-transplant: A prospective study. Pediatr Transplant 2017;21(5).[Epub ahead of print] doi:10.1111/petr.12942 Go to original source...
  31. Mitterhofer AP, Tinti F, Pietropaolo V, Umbro I, Anzivino E, Bellizzi A, Zavatto A, Poli L, Berloco PB, Taliani G. Role of BK virus infection in end-stage renal disease patients waiting for kidney transplantation--viral replication dynamics from pre- to post-transplant. Clin Transplant 2014;28(3):299-306. Go to PubMed...
  32. Masutani K, Ninomiya T, Randhawa P. HLA-A2, HLA-B44 and HLA-DR15 are associated with lower risk of BK viremia. Nephrol Dial Transplant 2013;28(12):3119-26. Go to PubMed...
  33. Kauke T, Klimaschewski S, Schoenermarck U, Fischereder M, Dick A, Guba M, Stangl M, Werner J, Meiser B, Habicht A. Outcome after Desensitization in HLA or ABO-Incompatible Kidney Transplant Recipients: A Single Center Experience. PLoS One 2016;11(1):e0146075. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26730981 Go to PubMed...
  34. Sharif A, Alachkar N, Bagnasco S, Geetha D, Gupta G, Womer K, Arend L, Racusen L, Montgomery R, Kraus E. Incidence and outcomes of BK virus allograft nephropathy among ABO- and HLA-incompatible kidney transplant recipients. Clin J Am Soc Nephrol 2012;7(8):1320-7. Go to PubMed...
  35. Pham PT, Schaenman J, Pham PC. BK virus infection following kidney transplantation: an overview of risk factors, screening strategies, and therapeutic interventions. Curr Opin Organ Transplant 2014;19(4):401-12. Go to PubMed...
  36. Wingate JT, Brandenberger J, Weiss A, Scovel LG, Kuhr CS. Ureteral stent duration and the risk of BK polyomavirus viremia or bacteriuria after kidney transplantation. Transpl Infect Dis 2017;19(1).[Epub ahead of print] doi:10.1111/tid.12644 Go to original source... Go to PubMed...
  37. Viswesh V, Yost SE, Kaplan B. The prevalence and implications of BK virus replication in non-renal solid organ transplant recipients: A systematic review. Transplant Rev (Orlando) 2015;29(3):175-80. Go to PubMed...
  38. Ducharme-Smith A, Katz BZ, Bobrowski AE, Backer CL, Pahl E. BK polyomavirus infection in pediatric heart transplant recipients: a prospective study. Pediatr Transplant 2017;21(2).[Epub ahead of print] doi:10.1111/petr.12830 Go to original source... Go to PubMed...
  39. Umbro I, Tinti F, Muiesan P, Mitterhofer AP. Different behaviour of BK-virus infection in liver transplant recipients. World J Gastroenterol 2016;22(4):1532-40. Go to PubMed...
  40. Sharma SG, Nickeleit V, Herlitz LC, de Gonzalez AK, Stokes MB, Singh HK, Markowitz GS, D'Agati VD. BK polyoma virus nephropathy in the native kidney. Nephrol Dial Transplant. 2013;28(3):620-31. Go to PubMed...
  41. Yi SG, Knight RJ, Lunsford KE. BK virus as a mediator of graft dysfunction following kidney transplantation. Curr Opin Organ Transplant 2017;22(4):320-7. Go to PubMed...
  42. Sachdeva MS, Nada R, Jha V, Sakhuja V, Joshi K. The high incidence of BK polyoma virus infection among renal transplant recipients in India. Transplantation 2004;77(3):429-31. Go to PubMed...
  43. Helanterä I, Hirsch HH, Wernli M, Ortiz F, Lempinen M, Räisänen-Sokolowski A, Auvinen E, Mannonen L, Lautenschlager I. Simultaneous BK Polyomavirus (BKPyV)-associated nephropathy and hemorrhagic cystitis after living donor kidney transplantation. J Clin Virol 2016;76:4-7. Go to PubMed...
  44. Jun JB, Choi Y, Kim H, Lee SH, Jeong J, Jung J. BK polyomavirus encephalitis in a patient with thrombotic microangiopathy after an allogeneic hematopoietic stem cell transplant. Transpl Infect Dis 2016;18(6):950-3. Go to PubMed...
  45. El-Mouallem NJ, Paul AK. BK Virus-Associated Urinary Bladder Cancer in a Kidney Transplant Recipient: A Case Report and Review of the Pathogenesis. Am J Hematol Oncol 2017;13(3):15-20.
  46. Salvatore SP, Myers-Gurevitch PM, Chu S, Robinson BD, Dadhania D, Seshan SV. Polyoma (BK) virus associated urothelial carcinoma originating within a renal allograft five years following resolution of polyoma virus nephropathy. Clin Nephrol 2016;85(3):179-83. Go to PubMed...
  47. Everly MJ, Briley KP, Haisch CE, Dieplinger G, Bolin P, Kendrick SA, Morgan C, Maldonado AQ, Rebellato LM. Racial differences in incident de novo donor-specific anti-HLA antibody among primary renal allograft recipients: results from a single center cohort study. Transpl Int 2017;30(6):566-78. Go to PubMed...
  48. Sawinski D, Forde KA, Trofe-Clark J, Patel P, Olivera B, Goral S, Bloom RD. Persistent BK viremia does not increase intermediate-term graft loss but is associated with de novo donor-specific antibodies. J Am Soc Nephrol 2015;26(4):966-75. Go to PubMed...
  49. Gera DN, Shah MK, Ghodela VA, Kute VB, Trivedi HL. De Novo Collapsing Glomerulopathy in Renal Allograft in Association with BK Virus Nephropathy in a Child and Stabilization of Renal Function by Elimination of Viremia. Indian J Nephrol 2017;27(3):228-30.
  50. Chikeka IO, Paulk A, Haririan A, Papadimitriou JC, Drachenberg CB. Concurrent cytomegalovirus glomerulitis and BK polyomavirus-associated nephropathy in a kidney allograft biopsy. Transpl Infect Dis 2016;18(2):247-50. Go to PubMed...
  51. Hodowanec AC, Simon DM. BK virus screening and management practices among US renal transplant programs: a survey. Transpl Int 2015;28(11):1339-41. Go to PubMed...
  52. Randhawa P, Ramos E. BK viral nephropathy: an overview. Transplant Rev 2007;21(2):77-85.
  53. Funk GA, Gosert R, Comoli P, Ginevri F, Hirsch HH. Polyomavirus BK replication dynamics in vivo and in silico to predict cytopathology and viral clearance in kidney transplants. Am J Transplant 2008;8(11):2368-77. Go to PubMed...
  54. Chon WJ, Aggarwal N, Kocherginsky M, Kane B, Sutor J, Josephson MA. High-level viruria as a screening tool for BK virus nephropathy in renal transplant recipients. Kidney Res Clin Pract 2016;35(3):176-81. Go to PubMed...
  55. Boan P, Hewison C, Swaminathan R, Irish A, Warr K, Sinniah R, Pryce TM, Flexman J. Optimal use of plasma and urine BK viral loads for screening and predicting BK nephropathy. BMC Infect Dis 2016;16:342-8. Go to PubMed...
  56. Boran M, Yildirim T, Boran E, Boran M, Kilic H. Late-Onset BK Viruria in Renal Transplant Recipients. Transplant Proc 2015;47(6):1786-9. Go to PubMed...
  57. Agrawal N, Echenique IA, Meehan SM, Limaye AP, Cook L, Chang A, Harland RC, Javaid B, Kadambi PV, Matushek S, Williams J, Josephson MA. Variability in assessing for BK viremia: whole blood is not reliable and plasma is not above reproach - a retrospective analysis. Transpl Int 2017;30(7):670-8. Go to PubMed...
  58. Barbosa D, Kahwaji J, Puliyanda D, Mirocha J, Reinsmoen N, Lai CH, Villicana R, Peng A, Jordan SC, Vo A, Toyoda M. Polyomavirus BK viremia in kidney transplant recipients after desensitization with IVIG and rituximab. Transplantation 2014;97(7):755-61. Go to PubMed...
  59. Govind S, Hockley J, Morris C. Collaborative Study Group. 2015. Collaborative Study to establish the 1st WHO International Standard for BKV DNA for nucleic acid amplification technique (NAT)-based assays. WHO/BS/2015.2270. WHO, Geneva, Switzerland. Available from: http://apps.who.int/iris/handle/10665/197764
  60. Kamel M, Kadian M, Salazar MN, Mohan P, Self S, Srinivas T, Salas MA. A Case of BK Nephropathy without Detectable Viremia or Viruria. Am J Case Rep 2015;16:532-5. Go to PubMed...
  61. Nankivell BJ, Renthawa J, Jeoffreys N, Kable K, O'Connell PJ, Chapman JR, Wong G, Sharma RN. Clinical Utility of Urinary Cytology to Detect BK Viral Nephropathy. Transplantation 2015;99(8):1715-22. Go to PubMed...
  62. Hassan S, Mittal C, Amer S, Khalid F, Patel A, Delbusto R, Samuel L, Alangaden G, Ramesh M. Currently recommended BK virus (BKV) plasma viral load cutoff of ≥4 log10/mL underestimates the diagnosis of BKV-associated nephropathy: a single transplant center experience. Transpl Infect Dis 2014;16(1):55-60. Go to PubMed...
  63. Castro T, Fink MC, Figueiredo M, Braz-Silva PH, Pannuti CM, Ortega KL, Gallottini M. Polyomavirus BK and JC in individuals with chronic kidney failure, kidney transplantation, and healthy controls. J Clin Virol 2017;89:5-9. Go to PubMed...
  64. Dadhania D, Snopkowski C, Ding R, Muthukumar T, Lee J, Bang H, Sharma VK, Seshan S, August P, Kapur S, Suthanthiran M. Validation of noninvasive diagnosis of BK virus nephropathy and identification of prognostic biomarkers. Transplantation 2010;90(2):189-97. Go to PubMed...
  65. Singh HK, Reisner H, Derebail VK, Kozlowski T, Nickeleit V. Polyomavirus nephropathy: quantitative urinary polyomavirus-Haufen testing accurately predicts the degree of intrarenal viral disease. Transplantation 2015;99(3):609-15. Go to PubMed...
  66. Laskin BL, Singh HK, Beier UH, Moatz T, Furth SL, Bunin N, Witte D, Goebel J, Davies SM, Dandoy C, Jodele S, Nickeleit V. The Noninvasive Urinary Polyomavirus Haufen Test Predicts BK Virus Nephropathy in Children After Hematopoietic Cell Transplantation: A Pilot Study. Transplantation 2016;100(10):81-7. Go to PubMed...
  67. Bardak S, Turgutalp K, Balli E, Coºkun Yilmaz B, Gürses İ, Esen K, Demir S, Kiykim A. BK virus nephropathy in a renal transplant patient: Potential role of electron microscopy in diagnosis. Nefrologia 2016;36(5):565-7. Go to PubMed...
  68. Randhawa P, Bohl D, Brennan D, Ruppert K, Ramaswami B, Storch G, March J, Shapiro R, Viscidi R. Longitudinal analysis of levels of immunoglobulins against BK virus capsid proteins in kidney transplant recipients. Clin Vaccine Immunol 2008;15(10):1564-71. Go to PubMed...
  69. Drachenberg CB, Papadimitriou JC, Hirsch HH, Wali R, Crowder C, Nogueira J, Cangro CB, Mendley S, Mian A, Ramos E. Histological patterns of polyomavirus nephropathy: correlation with graft outcome and viral load. Am J Transplant 2004;4(12):2082-92. Go to PubMed...
  70. Petrogiannis-Haliotis T, Sakoulas G, Kirby J, Koralnik IJ, Dvorak AM, Monahan-Earley R, DE Girolami PC, DE Girolami U, Upton M, Major EO, Pfister LA, Joseph JT. BK-related polyomavirus vasculopathy in a renal-transplant recipient. N Engl J Med 2001;345(17):1250-5. Go to PubMed...
  71. Menter T, Mayr M, Schaub S, Mihatsch MJ, Hirsch HH, Hopfer H. Pathology of resolving polyomavirus-associated nephropathy. Am J Transplant 2013;13(6):1474-83. Go to PubMed...
  72. Liptak P, Kemeny E, Ivanyi B. Primer: histopathology of polyomavirus-associated nephropathy in renal allografts. Nat Clin Pract Nephrol 2006;2(11):631-6. Go to PubMed...
  73. Nankivell BJ, Renthawa J, Sharma RN, Kable K, O'Connell PJ, Chapman JR. BK Virus Nephropathy: Histological Evolution by Sequential Pathology. Am J Transplant 2017;17(8):2065-77. Go to PubMed...
  74. Sawinski D, Goral S. BK virus infection: an update on diagnosis and treatment. Nephrol Dial Transplant 2015;30(2):209-17. Go to PubMed...
  75. Schmid H, Nitschko H, Gerth J, Kliem V, Henger A, Cohen CD, Schlöndorff D, Gröne HJ, Kretzler M. Polyomavirus DNA and RNA detection in renal allograft biopsies: results from a European multicenter study. Transplantation 2005;80(5):600-4. Go to PubMed...
  76. Azar MM, Assi R, Valika AK, Banach DB, Hall IE, Landry ML, Malinis MF. Graft loss among renal-transplant recipients with early reduction of immunosuppression for BK viremia. World J Transplant 2017;7(5):269-75. Go to PubMed...
  77. Elfadawy N, Flechner SM, Schold JD, Srinivas TR, Poggio E, Fatica R, Avery R, Mossad SB. Transient versus persistent BK viremia and long-term outcomes after kidney and kidney-pancreas transplantation. Clin J Am Soc Nephrol 2014;9(3):553-61. Go to PubMed...
  78. Westphal SG, Lyden ER, Langewisch ED, Miles CD. BK viremia surveillance and outcomes in simultaneous pancreas-kidney transplant recipients. Clin Transplant 2017;31(8).[Epub ahead of print] doi:10.1111/ctr.13010 Go to original source... Go to PubMed...
  79. Drachenberg CB, Papadimitriou JC, Chaudhry MR, Ugarte R, Mavanur M, Thomas B, Cangro C, Costa N, Ramos E, Weir MR, Haririan A. Histological Evolution of BK Virus-Associated Nephropathy: Importance of Integrating Clinical and Pathological Findings. Am J Transplant 2017;17(8):2078-91. Go to PubMed...
  80. Yoon SH, Cho JH, Jung HY, Choi JY, Park SH, Kim YL, Kim HK, Huh S, Kim CD. Clinical impact of BK virus surveillance on outcomes in kidney transplant recipients. Transplant Proc 2015;47(3):660-5. Go to PubMed...
  81. Randhawa P, Pastrana DV, Zeng G, Huang Y, Shapiro R, Sood P, Puttarajappa C, Berger M, Hariharan S, Buck CB. Commercially available immunoglobulins contain virus neutralizing antibodies against all major genotypes of polyomavirus BK. Am J Transplant 2015;15(4):1014-20. Go to PubMed...
  82. Vu D, Shah T, Ansari J, Naraghi R, Min D. Efficacy of intravenous immunoglobulin in the treatment of persistent BK viremia and BK virus nephropathy in renal transplant recipients. Transplant Proc 2015;47(2):394-8. Go to PubMed...
  83. Gelfand EW. Intravenous immune globulin in autoimmune and inflammatory diseases. N Engl J Med 2012;367(21):2015-25. Go to PubMed...
  84. Simard-Meilleur MC, Bodson-Clermont P, St-Louis G, Pâquet MR, Girardin C, Fortin MC, Cardinal H, Hébert MJ, Lévesque R, Renoult E. Stabilization of renal function after the first year of follow-up in kidney transplant recipients treated for significant BK polyomavirus infection or BK polyomavirus-associated nephropathy. Transpl Infect Dis 2017;19(3).[Epub ahead of print] doi:10.1111/tid.12681 Go to original source... Go to PubMed...
  85. Guasch A, Roy-Chaudhury P, Woodle ES, Fitzsimmons W, Holman J, First MR; FK778 BK Nephropathy Study Group. Assessment of efficacy and safety of FK778 in comparison with standard care in renal transplant recipients with untreated BK nephropathy. Transplantation 2010;90(8):891-7. Go to PubMed...
  86. Jaw J, Hill P, Goodman D. Combination of Leflunomide and Everolimus for treatment of BK virus nephropathy. Nephrology (Carlton) 2017;22(4):326-29. Go to PubMed...
  87. Kuten SA, Patel SJ, Knight RJ, Gaber LW, DeVos JM, Gaber AO. Observations on the use of cidofovir for BK virus infection in renal transplantation. Transpl Infect Dis 2014;16(6):975-83. Go to PubMed...
  88. Papanicolaou GA, Lee YJ, Young JW, Seshan SV, Boruchov AM, Chittick G, Momméja-Marin H, Glezerman IG. Brincidofovir for polyomavirus-associated nephropathy after allogeneic hematopoietic stem cell transplantation. Am J Kidney Dis 2015;65(5):780-4. Go to PubMed...
  89. Knoll GA, Humar A, Fergusson D, Johnston O, House AA, Kim SJ, Ramsay T, Chassé M, Pang X, Zaltzman J, Cockfield S, Cantarovich M, Karpinski M, Lebel L, Gill JS. Levofloxacin for BK virus prophylaxis following kidney transplantation: a randomized clinical trial. JAMA 2014;312(20):2106-14. Go to PubMed...
  90. Krejci K, Tichy T, Bachleda P, Zadrazil J. Calcineurin inhibitor-induced renal allograft nephrotoxicity. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2010;154(4):297-306. Go to PubMed...
  91. Belliere J, Kamar N, Mengelle C, Allal A, Sallusto F, Doumerc N, Game X, Congy-Jolivet N, Esposito L, Debiol B, Rostaing L. Pilot conversion trial from mycophenolic acid to everolimus in ABO-incompatible kidney-transplant recipients with BK viruria and/or viremia. Transpl Int 2016;29(3):315-22. Go to PubMed...
  92. Dave H, Luo M, Blaney JW, Patel S, Barese C, Cruz CR, Shpall EJ, Bollard CM, Hanley PJ. Toward a Rapid Production of Multivirus-Specific T Cells Targeting BKV, Adenovirus, CMV, and EBV from Umbilical Cord Blood. Mol Ther Methods Clin Dev 2017;5:13-21. Go to PubMed...
  93. Dasari V, Schuessler A, Smith C, Wong Y, Miles JJ, Smyth MJ, Ambalathingal G, Francis R, Campbell S, Chambers D, Khanna R. Prophylactic and therapeutic adenoviral vector-based multivirus-specific T-cell immunotherapy for transplant patients. Mol Ther Methods Clin Dev 2016;3:16058. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997746/ Go to PubMed...
  94. Huang J, Danovitch G, Pham PT, Bunnapradist S, Huang E. Kidney retransplantation for BK virus nephropathy with active viremia without allograft nephrectomy. J Nephrol 2015;28(6):773-7. Go to PubMed...