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KMID : 0361120080220010013
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Korean Journal of Transplantation
2008 Volume.22 No. 1 p.13 ~ p.20
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Polyomavirus Disease in Kidney Transplantation
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Hwang Young-Hwan
Ahn Curie
Kwon Oh-Jung
Kim Sang-Il
Kim Yong-Lim
Choi Yeong-Jin
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Abstract
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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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KEYWORD
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Polyomavirus infections, Kidney transplantation, BK virus
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