Journal ArticleDOI
Polyomavirus disease under new immunosuppressive drugs: a cause of renal graft dysfunction and graft loss.
Isabelle Binet,Volker Nickeleit,Hans H. Hirsch,Olivier Prince,P. Dalquen,Fred Gudat,Michael J. Mihatsch,Gilbert Thiel +7 more
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TLDR
Recurrent rejection episodes and high dose immunosuppressive therapy, including tacrolimus, are risk factors for manifest PV kidney graft infection, which has an ominous prognosis.Abstract:
Background Manifest polyomavirus (PV) renal graft infection is a rare complication. We diagnosed 5 cases among 70 kidney recipients undergoing transplants since December 1995; however, there were no cases at our institution before December 1995. Method. To identify risk factors promoting manifest PV graft infection, we compared those 5 patients with kidney recipients who had signs of PV replication but no manifest graft infection (n=23, control group). PV replication was judged by the presence of intranuclear inclusion cells in the urine. Results. Before the infection, five of five patients had recurrent rejection episodes. All were switched from cyclosporine A to high dose tacrolimus as rescue therapy. Infection was diagnosed histologically 9±2 months posttransplantation; it persisted and led to graft loss in four of five patients. In control patients, graft function was stable, 1 of 23 patients were switched to tacrolimus as rescue therapy, and graft loss occurred in 4 of 23 patients. Conclusion. Recurrent rejection episodes and high dose immunosuppressive therapy, including tacrolimus, are risk factors for manifest PV kidney graft infection, which has an ominous prognosis.read more
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Prospective Study of Polyomavirus Type BK Replication and Nephropathy in Renal-Transplant Recipients
Hans H. Hirsch,Wendy Knowles,Michael Dickenmann,Jakob Passweg,Thomas Klimkait,Michael J. Mihatsch,Jürg Steiger +6 more
TL;DR: BKV nephropathy in renal-transplant recipients represents a secondary infection associated with rejection and its treatment in most cases and could be monitored by measuring the viral load in plasma.
Journal ArticleDOI
Polyomavirus-Associated Nephropathy in Renal Transplantation: Interdisciplinary Analyses and Recommendations
Hans H. Hirsch,Daniel C. Brennan,Cinthia B. Drachenberg,Fabrizio Ginevri,Jennifer Gordon,Ajit P. Limaye,Michael J. Mihatsch,Volker Nickeleit,Emilia Ramos,Parmjeet Randhawa,Ron Shapiro,Juerg Steiger,Manikkam Suthanthiran,Jennifer Trofe +13 more
TL;DR: It is recommended that all renal transplant recipients should be screened for BKV replication in the urine every three months during the first two years posttransplant; and if PVAN and concurrent acute rejection is diagnosed, antirejection treatment should be considered, coupled with subsequently reducing immunosuppression.
Journal ArticleDOI
Polyomavirus Infection of Renal Allograft Recipients From Latent Infection to Manifest Disease
Volker Nickeleit,Hans H. Hirsch,Isabelle Binet,Fred Gudat,Olivier D. Prince,P. Dalquen,Gilbert Thiel,Michael J. Mihatsch +7 more
TL;DR: It is concluded that a manifest renal allograft infection with PV (BK strain) can persist in heavily immunosuppressed patients with recurrent rejection episodes.
Journal ArticleDOI
Testing for polyomavirus type BK DNA in plasma to identify renal-allograft recipients with viral nephropathy.
Volker Nickeleit,Thomas Klimkait,Isabelle Binet,P. Dalquen,V Del Zenero,Gilbert Thiel,Michael J. Mihatsch,Hans H. Hirsch +7 more
TL;DR: Testing for BK virus DNA in plasma from renal-allograft recipients with use of the polymerase chain reaction is a sensitive and specific method for identifying viral nephropathy.
Journal ArticleDOI
BK polyomavirus in solid organ transplantation.
Hans H. Hirsch,Parmjeet Randhawa +1 more
TL;DR: Screening kidney transplant patients for BK polyomavirus replication in urine and blood has become the key recommendation to guide the reduction of immunosuppression in patients with BKV viremia.
References
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Journal ArticleDOI
New human papovavirus (b.k.) isolated from urine after renal transplantation
TL;DR: The isolation of a new papovavirus from the urine of a renal allograft recipient with ureteric obstruction is described and this virus is not identical with any of the previously described members of the polyoma subgroup.
Journal ArticleDOI
Persistence of DNA Sequences of BK Virus and JC Virus in Normal Human Tissues and in Diseased Tissues
Peter M. Chesters,D.J. Mccance +1 more
TL;DR: Investigation of normal and diseased brain tissue, including tissue from six subjects with multiple sclerosis, failed to reveal the presence of either JCV DNA or BKV DNA, and viral DNA detected appeared not to be integrated with host DNA and to be isolated in foci.
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Association of BK Viruria with Hemorrhagic Cystitis in Recipients of Bone Marrow Transplants
TL;DR: It is concluded that reactivation of BK virus may account for a substantial proportion of late-onset, long-lasting hemorrhagic cystitis in recipients of bone marrow transplants.
Journal ArticleDOI
Human Polyomavirus Infections with JC Virus and BK Virus in Renal Transplant Patients
TL;DR: Polyomavirus replication was associated with an increased frequency of transplant related complications and Antibody increases to BK virus were associated with a rising seurum creatinine and need for transplant biopsy.