J Korean Soc Transplant.
2008 Jun;22(1):13-20.
Polyomavirus Disease in Kidney Transplantation
- Affiliations
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- 1Department of Internal Medicine, Eulji General Hospital, Seoul, Korea.
- 2Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea. curie@snu.ac.kr
- 3Transplantation Research Institute, Seoul National University, Seoul, Korea.
- 4Department of Surgery, College of Medicine, Hanyang University, Seoul, Korea.
- 5Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- 6Department of Internal Medicine, Kyungpook National University Hospital, Seoul, Korea.
- 7Department of Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Abstract
- Polyomavirus disease is a re-emerging infectious complication in renal transplantation. It manifests as symptomless renal dysfunction and progresses to graft loss unless the prompt diagnosis and intervention are initiated. A gold standard for diagnosis is the renal biopsy. Recently, the molecular diagnosis can be made using plasma PCR technique before histologic confirmation. Reduction of immunosuppression is a mainstay of treatment. Leflunomide and other antiviral agents could be used successfully in selected cases. The screening using urine decoy cell and subsequent plasma PCR may detect the BK viral replication, and preemptive intervention will prevent development of overt nephropathy without risk of rejection. This review will cover the recent advances and clinical issues in diagnosis and management of polyomavirus disease, mainly BK virus associated nephropathy.
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