title: Renal allograft loss as the result of polyomavirus interstitial nephritis after simultaneous kidney-pancreas transplantation: results with kidney retransplantation.
abstract: BACKGROUND
  Polyomavirus (PV) infection in kidney transplant patients has been reported to cause interstitial nephritis and subsequent graft loss. The cornerstone of current therapy is a reduction in immunosuppression, which can subsequently lead to kidney allograft rejection. This dilemma becomes even more challenging in the setting of simultaneous kidney-pancreas transplantation, because a reduction in immunosuppression may result in rejection of the pancreas allograft. Antiviral therapy has not been shown to be clinically successful in decreasing the risk of graft loss secondary to PV infection. Furthermore, because of limited experience, the decision to perform retransplantation in patients who lost their primary kidney grafts to PV interstitial nephritis becomes a difficult one.
  
  
  METHODS
  Retrospective review and case studies.
  
  
  RESULTS
  We report two successful living donor kidney retransplants in simultaneous kidney-pancreas transplant patients who lost their first kidney grafts to PV infection. Both patients are receiving rimantadine therapy and performing well, with functioning kidney and pancreas grafts and no evidence of recurrent PV interstitial nephritis 22 and 37 months after retransplantation.
  
  
  CONCLUSIONS
  Although follow-up is limited, our initial experience would indicate that graft loss secondary to PV interstitial nephritis is not an absolute contraindication for kidney retransplantation.
authors.affiliation: Department of Pharmacy, University of Tennessee-Memphis, Memphis, TN, USA.
authors.forename: Ahmed H
authors.initials: AH
authors.lastname: Al-Jedai
authors.forename: Marsha R
authors.initials: MR
authors.lastname: Honaker
authors.forename: Jennifer
authors.initials: J
authors.lastname: Trofe
authors.forename: M Francesca
authors.initials: MF
authors.lastname: Egidi
authors.forename: Lillian W
authors.initials: LW
authors.lastname: Gaber
authors.forename: A Osama
authors.initials: AO
authors.lastname: Gaber
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Stratta
mesh_terms: D000328:Adult; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000821:virology*; D016035:Pancreas Transplantation; D027601:Polyomavirus Infections / Q000150:complications*; D012086:Reoperation; D014184:Transplantation, Homologous; D014412:Tumor Virus Infections / Q000150:complications*