Preemptive Retransplantation for BK Virus Nephropathy: Successful Outcome Despite Active Viremia

• Published in: American journal of transplantation Vol. 6; no. 1; pp. 209 - 213
• Main Authors: Womer, K. L., Meier‐Kriesche, H.‐U., Patton, P. R., Dibadj, K., Bucci, C. M., Foley, D., Fujita, S., Croker, B. P., Howard, R. J., Srinivas, T. R., Kaplan, B.
• Format: Journal Article
• Language: English
• Published: Oxford UK Munksgaard International Publishers 01.01.2006; Blackwell
• Subjects: Adult; Biological and medical sciences; BK Virus - isolation & purification; Chronic allograft nephropathy; Female; Graft Rejection - virology; Humans; Kidney Diseases - surgery; Kidney Diseases - virology; kidney transplant; Kidney Transplantation; Medical sciences; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Polyomavirus Infections - complications; Polyomavirus Infections - diagnosis; polyomavirus nephropathy; Renal failure; Reoperation; retransplantation; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome; viremia; Viremia - diagnosis; Graft(material); Prognosis; Viremia; Homograft; BK; Transplantation; Papovaviridae; Homotransplantation; Prevention; polyomavirus nephropathy; Surgery; Graft; Evolution; Kidney disease; Chronic allograft nephropathy; Opportunistic infection; Reoperation; Urinary system disease; Polyomavirus; kidney transplant; retransplantation; BK virus; Infection; Virus; Rejection; Chronic; Nephropathy; Treatment; Viral disease; Renal failure
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/j.1600-6143.2005.01137.x

BK virus nephropathy (BKVN) is now recognized as a major cause of renal allograft loss. Recent reports suggest that retransplantation in patients with graft loss due to BKVN is safe after return to dialysis. Since early transplantation is associated with improved outcomes, it would be advantageous if this procedure could be performed prior to ultimate graft loss. However, little data are available regarding the safety of this approach during active viremia. In this report, we describe successful preemptive retransplantation with simultaneous allograft nephrectomy in two patients with active BKVN and viremia at the time of surgery. With 21‐ and 12‐month follow‐up, respectively, both patients have stable allograft function and no evidence for active viral replication. We conclude that preemptive retransplantation can be considered in patients with failing allografts due to BKVN.