Diagnostics, treatment, and immune response in BK polyomavirus infection after pediatric kidney transplantation.

After pediatric kidney transplantation BK polyomavirus (BKPyV) infections are associated with an increased risk of graft loss by BKPyV-associated nephropathy (BkPyVAN). However, suitable prognostic markers for the individual outcome of BKPyV infections are missing and the management of therapeutic i...

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Publicado en:Pediatric Nephrology Vol. 35; no. 3; pp. 375 - 383
Autores principales: Ahlenstiel-Grunow, Thurid, Pape, Lars
Formato: algorithm exam questions pictorial review tables/charts Journal Article
Publicado: Springer Nature Mar2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2020
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00467-018-4164-3
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        atl: Diagnostics, treatment, and immune response in BK polyomavirus infection after pediatric kidney transplantation.
      aug:
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          Ahlenstiel-Grunow, Thurid
          Pape, Lars
        affil: Department of Pediatric Kidney, Liver and Metabolic Disease, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
      sug:
        subj:
          Polyomavirus Infections Diagnosis
          Kidney Transplantation Adverse Effects
          Polyomavirus Infections Therapy
          Polyomavirus Infections Immunology
          Child
          Kidney Diseases Risk Factors
          Immunosuppression
          Child: 6-12 years
      ab: After pediatric kidney transplantation BK polyomavirus (BKPyV) infections are associated with an increased risk of graft loss by BKPyV-associated nephropathy (BkPyVAN). However, suitable prognostic markers for the individual outcome of BKPyV infections are missing and the management of therapeutic interventions remains a challenge to the success of pediatric kidney transplantation. This review gives an overview on current diagnostic and therapeutic strategies in the field of BKPyV infections after pediatric kidney transplantation. Methods determining the individual immune response to BKPyV are described and their usability is discussed. There is growing evidence that BKPyV-specific T cells (BKPyV-Tvis) may serve as prognostic markers in order to steer immunosuppressive therapy in pediatric kidney recipients with BKPyV viremia in future. Prospective randomized trials in viremic kidney recipients comparing Tvis-steered therapeutic intervention with standard reduction of immunosuppression are needed before implementation of BKPyV-Tvis monitoring in routine care of BKPyV infections.
      pubtype: Academic Journal
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        exam questions
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    language: English
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