loading page

Biopsy proven BK virus nephropathy in kidney transplant recepients: A multi-central study from Turkey (BK-TURK STUDY)
  • +45
  • Ozkan Gungor,
  • Hamad Dheir,
  • huseyin toz,
  • Abdulmecit Yildiz,
  • Ayse Sinangil,
  • Erhan Tatar,
  • Gulay Asci,
  • Eda Altun,
  • Orcun Altunoren,
  • Suheyla Apaydin,
  • Alparslan Ersoy,
  • Berfu Korucu,
  • Seda Safak,
  • Ulver Derici,
  • Saliha Yildirim,
  • Nurhan Seyahi,
  • Seyda Gul Ozcan,
  • Kadir Gokhan Atilgan,
  • Mehmet Deniz Ayli,
  • Caner Cavdar,
  • Ozcan Uzun,
  • Rahmi Yilmaz,
  • Arda Erdut,
  • Mustafa Sevinc,
  • Umut Kasapoğlu,
  • Ismail Kocyigit,
  • Cihan Uysal,
  • Kultigin Turkmen,
  • Hakan Ozer,
  • Arzu Velioglu,
  • Ebru Ok,
  • Bulent Kaya,
  • Zulfikar yılmaz,
  • Oktay Ozkan,
  • Egemen Cebeci,
  • Kenan Turgutalp,
  • Meltem Gursu,
  • Enver Yüksel,
  • Necmi Eren,
  • Erkan Dervisoglu,
  • Fatma Betul Guzel,
  • Gursel Yildiz,
  • Serkan Bakirdogen,
  • Ayca Inci,
  • Can Sevinc,
  • Özkan Ulutaş,
  • Aydin Turkmen,
  • Mahmud ISLAM
Ozkan Gungor
Turk Nefroloji Dernegi
Author Profile
Hamad Dheir
Turk Nefroloji Dernegi

Corresponding Author:[email protected]

Author Profile
huseyin toz
Turk Nefroloji Dernegi
Author Profile
Abdulmecit Yildiz
Turk Nefroloji Dernegi
Author Profile
Ayse Sinangil
Turk Nefroloji Dernegi
Author Profile
Erhan Tatar
Turk Nefroloji Dernegi
Author Profile
Gulay Asci
Turk Nefroloji Dernegi
Author Profile
Eda Altun
Turk Nefroloji Dernegi
Author Profile
Orcun Altunoren
Turk Nefroloji Dernegi
Author Profile
Suheyla Apaydin
Turk Nefroloji Dernegi
Author Profile
Alparslan Ersoy
Turk Nefroloji Dernegi
Author Profile
Berfu Korucu
Turk Nefroloji Dernegi
Author Profile
Seda Safak
Turk Nefroloji Dernegi
Author Profile
Ulver Derici
Turk Nefroloji Dernegi
Author Profile
Saliha Yildirim
Turk Nefroloji Dernegi
Author Profile
Nurhan Seyahi
Turk Nefroloji Dernegi
Author Profile
Seyda Gul Ozcan
Turk Nefroloji Dernegi
Author Profile
Kadir Gokhan Atilgan
Turk Nefroloji Dernegi
Author Profile
Mehmet Deniz Ayli
Turk Nefroloji Dernegi
Author Profile
Caner Cavdar
Turk Nefroloji Dernegi
Author Profile
Ozcan Uzun
Turk Nefroloji Dernegi
Author Profile
Rahmi Yilmaz
Turk Nefroloji Dernegi
Author Profile
Arda Erdut
Turk Nefroloji Dernegi
Author Profile
Mustafa Sevinc
Turk Nefroloji Dernegi
Author Profile
Umut Kasapoğlu
Turk Nefroloji Dernegi
Author Profile
Ismail Kocyigit
Turk Nefroloji Dernegi
Author Profile
Cihan Uysal
Turk Nefroloji Dernegi
Author Profile
Kultigin Turkmen
Turk Nefroloji Dernegi
Author Profile
Hakan Ozer
Turk Nefroloji Dernegi
Author Profile
Arzu Velioglu
Turk Nefroloji Dernegi
Author Profile
Ebru Ok
Turk Nefroloji Dernegi
Author Profile
Bulent Kaya
Turk Nefroloji Dernegi
Author Profile
Zulfikar yılmaz
Turk Nefroloji Dernegi
Author Profile
Oktay Ozkan
Turk Nefroloji Dernegi
Author Profile
Egemen Cebeci
Turk Nefroloji Dernegi
Author Profile
Kenan Turgutalp
Turk Nefroloji Dernegi
Author Profile
Meltem Gursu
Turk Nefroloji Dernegi
Author Profile
Enver Yüksel
Turk Nefroloji Dernegi
Author Profile
Necmi Eren
Turk Nefroloji Dernegi
Author Profile
Erkan Dervisoglu
Turk Nefroloji Dernegi
Author Profile
Fatma Betul Guzel
Turk Nefroloji Dernegi
Author Profile
Gursel Yildiz
Turk Nefroloji Dernegi
Author Profile
Serkan Bakirdogen
Turk Nefroloji Dernegi
Author Profile
Ayca Inci
Turk Nefroloji Dernegi
Author Profile
Can Sevinc
Turk Nefroloji Dernegi
Author Profile
Özkan Ulutaş
Turk Nefroloji Dernegi
Author Profile
Aydin Turkmen
Turk Nefroloji Dernegi
Author Profile
Mahmud ISLAM
Turk Nefroloji Dernegi
Author Profile

Abstract

Background: Polyomavirus BK virus infection is a significant complication of renal transplantation and is an important cause of allograft loss. Today, despite the innovations in the pharmaceutical industry, a curative treatment against the BK virus has not been developed. The management is not standardized and is generally based on reported experience from transplantation centers. However, the literature on the subject with large samples is limited. Therefore, we designed a study to present our countrywide experience with BK virus nephropathy (BKVN) in renal transplant recipients. Methods: Our study was conducted with thirty kidney transplant centers from all provinces of Turkey. Only cases with BKVN proven by allograft biopsy were included in our study. Demographic characteristics and laboratory values of the patients were obtained from the archives and electronic databases of the centers. Results: A total of 13.857 patients from 30 transplantation centers were screened. 207 BKVN cases proven by allograft biopsy were identified and included in the study. The mean age was 46.4±13.1, and 146 (70.5%) patients were male. Twenty-six patients did not receive any induction therapy, 144 patients received anti-T lymphocyte globulin (ATLG), and 37 patients received basiliximab after transplantation. 23.6% of the patients had acute rejection history in the first six months of renal transplantation. all were treated with pulse steroids, and 46 were also treated with ATLG. The mean time to diagnosis of BKVN was 15.8±22.2 months after transplantation. At the time of diagnosis, the patients’ mean creatinine level was 1.8±0.7 mg/dl, and the mean estimated glomerular filtration rate was 45.8±19.6 ml/min. While BKVN was solely reported in 181 cases, there were cellular rejection findings in 21 biopsy specimens and humoral rejection in 4 biopsy specimens. In addition of dose reduction or discontinuation of immunosuppressive drugs, eighteen patients were treated with cidofovir, 11 patients with leflunomide, 17 patients with quinolones, 15 patients with intravenous immunoglobulin (IVIG), five patients with cidofovir+IVIG, and 12 patients with leflunomide+IVIG. None of the patients who received leflunomide and leflunomide+IVIG had allograft loss. Allograft loss was observed in 12 (15%) of 78 patients treated with antivirals or immunomodulators. Allograft loss occurred in 32 patients (15%) during follow-up out of 207 patients with BKVN. Five patients were retransplanted, and none developed BKVN during the follow-up. Conclusions: BKVN is still a significant cause of allograft loss in kidney transplantation, which has not been fully elucidated. Leflunomide appears to be an effective treatment in these patients.