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- Title
BK virus infection in pediatric renal transplantation, a single center Iranian experience.
- Authors
Sharifian, Mostafa; Karimi, Abdollah; Rahmani, Zahra; Kiahosseini, Hoda; Tabatabaei, Sedigheh Rafiee; Jahromy, Mana Hadipour; Nafar, Mohsen; Simfroosh, Naser; Basiri, Abbas; Otukesh, Hassan; Esfandiar, Nasrin; Navidinia, Masoumeh; Kalantar, Ebrahim
- Abstract
Introduction: Viral infections are well known complications of transplant recipients. BK Virus (BKV) belongs to the polyomavirus family of double stranded non-enveloped DNA viruses. BK virus nephropathy (BKN) is an important cause of renal transplant dysfunction, especially in patients with high levels of immunosuppression. Up to 85 percent of adults have reportedly serologic evidence of exposure to the virus, suggesting the presence of asymptomatic, latent infection. Herein we present our experience in BKV infection and nephropathy in renal transplant children in Labbafinejad Hospital. Material & Method: Between January 1985 and November 2008, 334 kidney transplantations were performed in children under 15 years in Labbafinejad Hospital Tehran, mostly from Living Unrelated Donors (LURD). Immunosuppressive medications consist of prednisolone, Cyclosporin A and Mycophenolate Mofetil (Cellcept). Eleven patients received Basiliximab (Simulect) as adjunct induction therapy. BK Virus was tested in 103 urine samples from73 transplant patients who were in regular follow-up by Polymerase Chain Reaction (PCR) and in blood if patient was symptomatic. Decoy cells were also tested in patients who had a dramatic rise in plasma creatinine. Results: BK Virus particles were detected in 20 transplant children (27%) (19 in urine and one only in blood) of whom 3 patients had Decoy cells in pathologic examination of urine and a dramatic rise in plasma creatinine (BKN: 4%). PCR examination of blood for BK Virus was tested in 37 patients and was positive in only 3 of these patients. Immunosuppressive medications were reduced as first step of treatment for 3 patients with BKN, it was effective in 2 patients presenting with reduction of plasma creatinine. Cidofovir was used for third patient which was partially effective leaving a plasma creatinine of 1.9 mg/dl. Conclusion: BK Virus Nephropathy should be considered as a cause of each allograft dysfunction in transplant children.
- Subjects
TEHRAN (Iran); BK virus; VIRUS diseases; KIDNEY transplantation; CYCLOSPORINE; LATENT infection
- Publication
Cancer Therapy, 2009, Vol 7, p305
- ISSN
1543-9135
- Publication type
Article