Retransplantation in patients with graft loss caused by polyoma virus nephropathy.
The characteristics and outcome in 10 patients who underwent retransplantation after losing their renal grafts to BK virus-associated nephropathy (BKAN) are described. The patients underwent retransplantation at a mean of 13.3 months after failure of the first graft. Nephroureterectomy of the first graft was performed in seven patients. Maintenance immunosuppression regimens after the first and second grafts were similar, consisting of a combination of a calcineurin inhibitor, mycophenolate mofetil, and prednisone. BKAN recurred in one patient 8 months after retransplantation, but stabilization of graft function was achieved with a decrease in immunosuppression and treatment with low-dose cidofovir. After a mean follow-up of 34.6 months, all patients were found to have good graft function with a mean creatinine of 1.5 mg/dL. From this collective experience from five transplant centers (although the follow-up after retransplantation was not extensive), it can be concluded that patients with graft loss caused by BKAN can safely undergo retransplantation. The risk of recurrence does not seem to be increased in comparison with the first graft.
Ramos
Emilio
E
Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA. eramos@medicine.umaryland.edu
Vincenti
Flavio
F
Lu
Wei X
WX
Shapiro
Ron
R
Trofe
Jennifer
J
Stratta
Robert J
RJ
Jonsson
Johann
J
Randhawa
Parmjeet S
PS
Drachenberg
Cinthia B
CB
Papadimitriou
John C
JC
Weir
Matthew R
MR
Wali
Ravinder K
RK
D000328:Adult; D000368:Aged; D001739:BK Virus; D006084:Graft Rejection / Q000821:virology*; D006801:Humans; D007674:Kidney Diseases / Q000473:pathology / Q000601:surgery* / Q000821:virology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D027601:Polyomavirus Infections / Q000150:complications*; D012086:Reoperation; D014412:Tumor Virus Infections / Q000150:complications*