SUCCESSFUL BKVIRUS-SPECIFIC T CELLS THERAPY IN A KIDNEY TRANSPLANT RECIPIENT WITH PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY. The strategy for Progressive Multifocal Leukoencephalopathy (PML) in Solid Organ Transplant recipients primarily focuses on reducing immunosuppressive therapy. However, this approach offers limited efficacy and carries a high risk of graft loss. Here, we present the case
Composition of the neutralising antibody response predicts risk of BKvirus DNAaemia in recipients of kidney transplants. BK polyomavirus (BKV) DNAaemia occurs in 10% of recipients of kidney transplants, contributing to premature allograft failure. Evidence suggests disease is donor derived. Hypothetically, recipient infection with a different BKV serotype increases risk due to poorer
Infliximab Induction Lacks Efficacy and Increases BKVirus Infection in Deceased Donor Kidney Transplant Recipients Ischemia-reperfusion (IR) of a kidney transplant (KTx) upregulates tumor necrosis factor alpha (TNF) production that amplifies allograft inflammation and may negatively impact transplant outcomes. We tested the effects of blocking TNF peri-KTx via a randomized, double-blind in IFX (13.3%) vs. PLBO (4.9%, p=0.06). IFX induction therapy does not benefit recipients of kidney transplants from deceased donors on this IS regimen. Because the intervention unexpectedly increased rates of BKvirus infections, our findings underscore the complexities of targeting peri-transplant inflammation as a strategy to improve KTx outcomes.
Predictive Factors of BKVirus Development in Kidney Transplant Recipients and the Effect of Low-Dose Tacrolimus Plus Everolimus on Clinical Outcomes. This study aimed to determine the predictive factors of BKvirus viremia/nephropathy in kidney transplant recipients and to evaluate the effects of low-dose tacrolimus plus everolimus. This study included 3654 kidney transplant recipients . The patients were divided into 2 groups: group 1 were BKvirus negative (n = 3525, 96.5%) and group 2 were BKvirus positive (n = 129, viremia 3.5%, nephropathy 1%). Predictive factors were determined by receiver operating characteristic curve analysis and logistic regression models.We also divided and analyzed patients with BKvirus viremia/nephropathy into 2 groups according to immunosuppressive changes
Comparative Study of Intravenous Immunoglobulin and Leflunomide Combination Therapy With Intravenous Immunoglobulin Single Therapy in Kidney Transplant Patients With BKVirus Infection: Single-Center Clinical Trial. Nephropathy due to BKvirus infection is a major cause of graft dysfunction and loss. No specific treatment has been developed for the BKvirus. Here, we compared the combination of intravenous immunoglobulin and leflunomide versus intravenous immunoglobulin to treat BKvirus nephropathy after renal transplant. This study was a randomized controlled clinical trial. Sixteen kidney transplant patients with BKvirus infection were randomly divided into 2 groups; 1 group received intravenous immunoglobulin, and another group received leflunomide and intravenous immunoglobulin. P < .05
Polyoma BKVirus in Kidney Transplant Recipients: Screening, Monitoring, and Management. Polyomavirus BKvirus (BKPyV) infection is an important complication of kidney transplantation and allograft failure. The prevalence of viremia is 10%-15%, compared with BK-associated nephropathy (BKPyVAN) at 3%-5%. Given that there are no effective antiviral prophylaxis or treatment strategies for BKPyVAN
Urine exosomal bkv-miR-B1-5p and BKvirus nephropathy in kidney transplant recipients. Urine exosomal bkv-miR-B1-5p is associated with BKvirus (BKV) nephropathy (BKVN); however, its post-transplantation changes and predictability for BKVN have not been determined in kidney transplant recipients (KTRs). Urine exosomal bkv-miR-B1-5p and urine and plasma BKV DNA were measured at 2 weeks and 3, 6
BKvirus infection in allogeneic hematopoietic cell transplantation: An update on pathogenesis, immune responses, diagnosis and treatments. In hematopoietic cell transplantation (HCT) patients, BK polyomavirus (BKPyV) infection results in significant morbidity mainly due to hemorrhagic cystitis (HC). Despite increased knowledge acquired over recent decades, no treatment has shown effectiveness
BKvirus-associated nephropathy in a lung transplant patient: case report and literature review. BKvirus-associated nephropathy (BKVAN) is a relatively common cause of renal dysfunction in the first six months after renal transplantation. It arises from reactivation of the latent and usually harmless BKvirus (BKvirus) due to immunosuppression and other factors including some that are unique for acute allograft rejection but achieved good graft function. Urine microscopy and culture and renal ultrasound were normal. BKvirus PCR was positive at high levels in urine and blood. Renal biopsy subsequently confirmed BKVAN. The patient progressed to end-stage renal failure requiring haemodialysis despite reduction in immunosuppression, including switching mycophenolate for everolimus
The Importance of Kidney Medullary Tissue for the Accurate Diagnosis of BKVirus Allograft Nephropathy. The published tissue adequacy requirement of kidney medulla for BKvirus allograft nephropathy diagnosis lacks systematic verification and competes against potential increased procedural risks from deeper sampling. We evaluated whether the presence of kidney medulla improved the diagnostic rate of BK nephropathy in 2244 consecutive biopsy samples from 856 kidney transplants with detailed histologic and virologic results. Medulla was present in 821 samples (37%) and correlated with maximal core length (=0.35; <0.001). BKvirus allograft nephropathy occurred in 74 (3% overall) but increased to 5% (42 of 821) with medulla compared with 2% (32 of 1423) for cortical samples (<0.001). Biopsy
Immunologic Clearance of a BKVirus-associated Metastatic Renal Allograft Carcinoma. Metastatic carcinoma of a renal allograft is a rare but life threatening event with a difficult clinical management. Recent reports suggested a potential role of BK polyomavirus (BKPyV) in the development of urologic tract malignancies in kidney transplant recipients. We investigated a kidney-pancreas female -specific T cells and expanded cytokine-producing bright natural killer cells but no donor-specific antibodies. Finally, we found persistently elevated anti-BKvirus IgG titers and a specific anti-BKPyV T cell response. This investigation showed evidence for the potential oncogenic role of BKPyV in collecting duct carcinoma in renal allografts and demonstrated that immunosuppression withdrawal and IL-2
Use of Leflunomide as an Antiviral Agent with Everolimus for BKVirus Nephropathy Patients After Kidney Transplantation: A Case Series. BACKGROUND BKvirus nephropathy (BKVN) is the major cause of transplant renal dysfunction. However, a specific antiviral agent to treat it does not exist. One therapeutic option is to reduce use of immunosuppression drugs, which can cause allograft rejection
Allogeneic BKVirus-Specific T Cells for Progressive Multifocal Leukoencephalopathy. JC virus, the cause of progressive multifocal leukoencephalopathy (PML), and the BKvirus are genetically similar and share sequence homology in immunogenic proteins. We treated three immunosuppressed patients with PML with ex vivo-expanded, partially HLA-matched, third-party-produced, cryopreserved BKvirus
Calibration of BKVirus Nucleic Acid Amplification Testing to the 1st WHO International Standard for BKVirus Significant interassay variability in the quantification of BKvirus (BKV) DNA precludes establishing broadly applicable thresholds for the management of BKV infection in transplantation. The 1st WHO International Standard for BKV (primary standard) was introduced in 2016 as a common
BKVirus: A Cause for Concern in Thoracic Transplantation? Human BK polyomavirus (BKV) infection is poorly documented in heart and lung transplant patients. BK viruria and viremia have been estimated to affect 19% and 5% of heart transplant recipients, respectively. Data are limited, especially for lung transplantation, but the proportion of patients progressing from BK viruria to viremia or BKV
Long-term prognosis of BKvirus-associated nephropathy in kidney transplant recipients The long-term prognosis of BKvirus-associated nephropathy (BKVAN) in kidney transplant recipients (KTRs) is uncertain. We evaluated the long-term prognosis in KTRs with BKVAN and the clinical significance of BKVAN on post-transplant clinical outcome. We retrospectively analyzed the medical records of 582
Risk factors for BKvirus infection in living-donor renal transplant recipients: a single-center study from China BKvirus (BKV) infection has become one of the main complications in renal transplant recipients (RTRs) with the arrival of newer potent immunosuppressive agents. However, reports on the epidemiology of BKV infection and risk factors in Chinese population after renal transplantation
BKvirus pneumonia following stem cell transplantation against diffuse large Bâ€cell lymphoma The patient, a 70-year-old woman with diffuse large B-cell lymphoma (DLBCL), developed haemorrhagic cystitis associated with the BKvirus (BKV) and adenovirus type 11. Moreover, chest computed tomography showed ground-glass opacity (GGO) in the bilateral upper lobe, and we performed bronchoalveolar
Differential T cell response against BKvirus regulatory and structural antigens: A viral dynamics modelling approach BKvirus (BKV) associated nephropathy affects 1-10% of kidney transplant recipients, leading to graft failure in about 50% of cases. Immune responses against different BKV antigens have been shown to have a prognostic value for disease development. Data currently suggest
BKvirus-associated collecting duct carcinoma of the renal allograft in a kidney-pancreas allograft recipient BK polyomavirus (BKV) nephropathy is a major concern in renal transplantation. Its main consequence is graft loss, which occurs in more than 50% of the cases. renal cell carcinoma in renal allograft is a very rare event. Most of these tumors are papillary or clear cell carcinomas. We