title: Viral impact on long-term kidney graft function.
abstract: Acute rejection episodes are an important risk factor for the functional deterioration of solid-organ transplants. With more intense immunosuppressive protocols, the rate of acute rejection episodes has significantly declined in the last decade, but long-term graft function and graft survival are challenged by increasing viral complications. In this article, recent data on the role of adenovirus, polyomavirus BK and JC, cytomegalovirus, human herpesvirus-6 and -7, and parvovirus B19 on the long-term outcome of kidney transplantation are reviewed. An update on the pathophysiology of smoldering viral replication, associated inflammatory damage, and the presumed indirect viral effects is provided, and the implications for diagnostic tests and antiviral intervention are discussed.
authors.affiliation: Transplant Unit Research Laboratory, Transplantation and Liver Surgery Clinic, Helsinki University Hospital, and University of Helsinki, Meilahti, PL 340, Helsinki, FI-00029 HUS, Finland.
authors.forename: Ilkka
authors.initials: I
authors.lastname: Helanterä
authors.forename: Adrian
authors.initials: A
authors.lastname: Egli
authors.forename: Petri
authors.initials: P
authors.lastname: Koskinen
authors.forename: Irmeli
authors.initials: I
authors.lastname: Lautenschlager
authors.forename: Hans H
authors.initials: HH
authors.lastname: Hirsch
mesh_terms: D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000009:adverse effects*; D014777:Virus Diseases / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology*; D014780:Viruses / Q000145:classification / Q000302:isolation & purification
chemical_list: D007166:Immunosuppressive Agents