title: BK Virus Nephropathy in Heart Transplant Recipients.
abstract: Polyomavirus-associated nephropathy (PVAN) has become an important cause of kidney failure in kidney transplant recipients. PVAN is reported to affect 1% to 7% of kidney transplant recipients, leading to premature transplant loss in approximately 30% to 50% of diagnosed cases. PVAN occurring in the native kidneys of solid-organ transplant recipients other than kidney only recently has been noted. We report 2 cases of PVAN in heart transplant recipients, which brings the total of reported cases to 7. We briefly review the literature on the hypothesized causes of PVAN in kidney transplant recipients and comment on whether these same mechanisms also may cause PVAN in other solid-organ transplant recipients. PVAN should be considered in the differential diagnosis when evaluating worsening kidney function. BK viremia surveillance studies of nonkidney solid-organ recipients should be conducted to provide data to assist the transplantation community in deciding whether regular monitoring of nonkidney transplant recipients for BK viremia is indicated.
authors.affiliation: Division of Nephrology, Tufts Medical Center, Boston, MA.
authors.forename: Alin
authors.initials: A
authors.lastname: Joseph
authors.affiliation: Department of Pathology, Tufts Medical Center, Boston, MA.
authors.forename: Monika
authors.initials: M
authors.lastname: Pilichowska
authors.affiliation: Division of Infectious Diseases, Tufts Medical Center, Boston, MA.
authors.forename: Helen
authors.initials: H
authors.lastname: Boucher
authors.affiliation: Division of Cardiology, Tufts Medical Center, Boston, MA.
authors.forename: Michael
authors.initials: M
authors.lastname: Kiernan
authors.affiliation: Division of Cardiology, Tufts Medical Center, Boston, MA.
authors.forename: David
authors.initials: D
authors.lastname: DeNofrio
authors.affiliation: Division of Nephrology, Tufts Medical Center, Boston, MA. Electronic address: linker@tuftsmedicalcenter.org.
authors.forename: Lesley A
authors.initials: LA
authors.lastname: Inker
mesh_terms: D001739:BK Virus; D006084:Graft Rejection / Q000517:prevention & control; D016027:Heart Transplantation; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007668:Kidney / Q000473:pathology*; D007674:Kidney Diseases / Q000139:chemically induced / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D027601:Polyomavirus Infections / Q000139:chemically induced / Q000473:pathology*; D014412:Tumor Virus Infections / Q000139:chemically induced / Q000473:pathology*
chemical_list: D007166:Immunosuppressive Agents
keywords: BV virus nephropathy; Polyomavirus-associated nephropathy (PVAN); cardiac transplantation; heart transplant recipient; immunosuppression; interstitial fibrosis; kidney failure; native kidney; renal biopsy; tubular atrophy; viral reactivation