Perception, diagnosis and management of BK polyomavirus replication and disease in paediatric kidney transplant recipients in Europe

Pape, L. and Tonshoff, B. and Hirsch, H. H. and Members of the Working Group 'Transplantation' of the European S, Nephrology. (2016) Perception, diagnosis and management of BK polyomavirus replication and disease in paediatric kidney transplant recipients in Europe. Nephrol Dial Transplant, 31 (5). pp. 842-847.

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Official URL: https://edoc.unibas.ch/61880/

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BACKGROUND: BK polyomavirus (BKPyV)-associated nephropathy remains a challenge to the success of kidney transplantation, but its impact varies in different transplant programmes. METHODS: We investigated current practice through a web-based questionnaire made available by the European Society for Paediatric Nephrology (ESPN). RESULTS: A total of 90 physicians (23% of 391 active members) from 27 countries participated in the study. BKPyV-associated nephropathy is seen in 1-5% of patients annually with treatment success in 30-60%, and graft loss in 10%. Quantitative BKPyV load testing is available to <90% of physicians. Screening is performed in urine alone in 26%, in urine and blood in 37% and in blood alone in 37%. Most physicians (47%) screen at month 1, 2, 3, 6, 9 and 12 post-transplant. For patients with baseline renal function and plasma BKPyV loads of 10 000-1 000 000 copies/mL, 50% report performing renal biopsies prior to intervention. Intervention consists of reducing immunosuppression first with mycophenolate (Myc) in 40%, first with calcineurin inhibitors (CNI) in 29% or with both in 31%. Changing immunosuppressive drugs is considered mainly for biopsy-proven nephropathy consisting of discontinuation of Myc in 75%, and switching from CNI to mTOR inhibitors (52%). Cidofovir, intravenous immunoglobulin G, leflunomide and fluoroquinolones are used in less than one-third of this group. Furthermore, 66% of participants see a need for new antiviral drugs and new immmunosuppressive strategies, and almost 90% are willing to participate in future observational and interventional trials. CONCLUSION: This ESPN survey suggests that prompt translation of a positive screening test into reducing immunosuppression could improve outcomes.
Faculties and Departments:03 Faculty of Medicine > Departement Biomedizin > Division of Medical Microbiology > Transplantation Virology (Hirsch)
UniBasel Contributors:Hirsch, Hans H.
Item Type:Article, refereed
Article Subtype:Research Article
ISSN:1460-2385 (Electronic) 0931-0509 (Linking)
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:31 May 2020 21:21
Deposited On:31 May 2020 21:21

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