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BK virus infection, replication, and diseases in pediatric kidney transplantation

Acott, Philip ; Hirsch, Hans

In: Pediatric Nephrology, 2007, vol. 22, no. 9, p. 1243-1250

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    Titre
    • BK virus infection, replication, and diseases in pediatric kidney transplantation
    Auteur
    • Acott, Philip. Departments of Pediatrics and Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada
    • Hirsch, Hans. Transplantation Virology, Medical Microbiology, University of Basel, Petersplatz 10, 4003, Basel, Switzerland
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:319994
    Summary
    Polyomavirus-associated nephropathy is diagnosed in 2-8% of pediatric renal transplants and often precedes renal allograft dysfunction. Without intervention, however, significant graft dysfunction is observed in more than 50% of cases, although progressive early graft loss is reported in only three of 32 (9%) of cases. No specific treatment is available, but early decrease in immunosuppression is followed by declining human polyomavirus type 1 (BK virus) replication and improved outcome. The data suggest differences between pediatric and adult kidney transplantation. Possibly, pediatric patients might be able to mount a more vigorous BK virus-specific immune response than adult patients under similar modulation of immunosuppression. Also the role of cidofovir and leflunomide is still unresolved in pediatric patients. Larger prospective trials are needed to better define the impact of BK virus immunity for replication and disease as well as the role of reducing immunosuppression with or without cidofovir or leflunomide in pediatric transplant patients