title: Preemptive retransplantation for BK virus nephropathy: successful outcome despite active viremia.
abstract: 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.
authors.affiliation: Department of Medicine, University of Florida, College of Medicine, Gainesville, Florida, USA. womerkl@ufl.edu
authors.forename: K L
authors.initials: KL
authors.lastname: Womer
authors.forename: H-U
authors.initials: HU
authors.lastname: Meier-Kriesche
authors.forename: P R
authors.initials: PR
authors.lastname: Patton
authors.forename: K
authors.initials: K
authors.lastname: Dibadj
authors.forename: C M
authors.initials: CM
authors.lastname: Bucci
authors.forename: D
authors.initials: D
authors.lastname: Foley
authors.forename: S
authors.initials: S
authors.lastname: Fujita
authors.forename: B P
authors.initials: BP
authors.lastname: Croker
authors.forename: R J
authors.initials: RJ
authors.lastname: Howard
authors.forename: T R
authors.initials: TR
authors.lastname: Srinivas
authors.forename: B
authors.initials: B
authors.lastname: Kaplan
mesh_terms: D000328:Adult; D001739:BK Virus / Q000302:isolation & purification; D005260:Female; D006084:Graft Rejection / Q000821:virology*; D006801:Humans; D007674:Kidney Diseases / Q000601:surgery* / Q000821:virology; D016030:Kidney Transplantation; D027601:Polyomavirus Infections / Q000150:complications* / Q000175:diagnosis; D012086:Reoperation; D016896:Treatment Outcome; D014766:Viremia / Q000175:diagnosis