TY  - CHAP
T1  - Viral urological infections in kidney transplantation: BK polyomavirus (BKPyV)-associated diseases
T2  - Urogenital Infections and Inflammations
AU  - Schneidewind, Laila
AU  - Kranz, Jennifer 
ED  - Naber, Kurt G.
AD  - PD Dr. med. Laila Schneidewind, University Medical Center Rostock, Dept. of Urology, Rostock, Deutschland, E-mail: laila.schneidewind@med.uni-rostock.de
N2  - Viral infections continue to be prevalent and a major problem in kidney transplant recipients. One of the most significant viruses for renal transplant patients is BK polyomavirus (BKPyV), the cause of BKPyV-associated nephropathy (BKVAN). BKVAN is seen in ca. 5% of renal transplant recipients and can lead to chronic allograft failure or even graft loss in up to 50% of cases. We aimed to summarize current evidence for screening and treatment of BKVAN and important findings for further research. Therefore, we summed up the evidence from well-established guidelines and searched ClinicalTrials.gov for ongoing randomized controlled trials (RCTs). Best evidence for screening for BKPyV is summarized by the American Society of Transplantation Infectious Diseases Community of Practice in 2019: They recommend screening for BKPyV viremia monthly, until month nine, and then every three months until two years post-transplant. Extended screening after two years may be considered in pediatric patients. Stepwise immunosuppression reduction is recommended for BKPyV viremia >1,000 copies/ml. There is no evidence for an effective reduction of immunosuppression or therapy for BKVAN available at the moment and high-quality studies or RCTs are missing, so further high-quality research is warranted. Promising new approaches for evaluation of therapy of BKVAN in RCTs are virus-specific T cells and targeting the viral immune response. 
PY  - 2021
DA  - 2021/12/22
DO  - 10.5680/lhuii000069
LA  - en
L1  - https://books.publisso.de/de/system/getFile/790
UR  - https://dx.doi.org/10.5680/lhuii000069
L2  - https://dx.doi.org/10.5680/lhuii000069
PB  - German Medical Science GMS Publishing House
CY  - Berlin
ER  -