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| ORIGINAL ARTICLE |
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| Year : 2018 |
Volume
: 29 | Issue : 5 | Page
: 1073-1081 |
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Elimination of BK viremia in renal transplant recipients by optimization of immunosuppressive medications without precipitating acute rejection
Amitabh Jha1, Wasim Ahmed1, Abbas Pakkyara1, Faisal Shaheen2, Issa Al Salmi1
1 Department of Nephrology, Royal Hospital, Muscat, Oman
2 Saudi Center for Organ Transplantation, Riyadh, Saudi Arabia
Correspondence Address:
Dr. Issa Al Salmi
Department of Nephrology, Royal Hospital, P. O. Box 1331,P. C. 111, Muscat
Oman
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DOI: 10.4103/1319-2442.243976 PMID: 30381503 
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BK Polyomavirus-associated nephropathy (BKVAN) has been recognized as an increasing threat in renal transplant patients (RTP) for more than a decade. Reduction in immunosuppression is the mainstay of treatment through various options of treatment has been suggested. Published reports on these protocols have shown mixed results, and no randomized controlled trials have compared one strategy with another. In this context, we hypothesize that the appearance of BKV in the blood compels one to optimize the immunosuppression with possible long-term beneficial effects. We conducted a retrospective study among the RTP being followed up by the Renal Medicine Department at Royal Hospital who tested positive for BKV-polymerase chain reaction and whose immunosuppression was altered with a final aim to get rid of BK viremia, yet avoiding acute rejection. Results were analyzed by the clinical and statistical approach. Extensive literature review was carried out to look into the prevalence, prognosis, and treatment of BKVAN. In all the patients in whom BKV was detected alteration in immunosuppression resulted in eliminating the virus without precipitating acute rejection. The study shows that in the exercise of eliminating BKV by alteration of immunosuppression, we have “tailored” the immunosuppression in each particular RTPs, without precipitating acute rejection. |
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