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Authors Ison MG, Parker M, Stosor V, Kaufman DB
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Journal Transplantation Volume: 87 Issue: 4 Pages: 525-30
Publish Date 2009 Feb 27
PubMed ID 19307788
Abstract

BK nephropathy (BKVN) is a significant cause of graft dysfunction in kidney transplant recipients, but its course in simultaneous pancreas-kidney (SPK) recipients is less well studied. The presence of dual organs limits the ability to reduce maintenance immunosuppression, typically the first intervention in the management of BKVN.A single center, retrospective review was conducted of 205 SPK transplants performed from January 1, 2000 to April 30, 2006.The 5-year actuarial cumulative rate of BKVN was 5.6%. Diagnosis occurred at a median of 20 months after transplant; mean serum creatinine was 2.6, and geometric mean BK serum viral load was 709,274 copies/mL at diagnosis. There was no statistical difference in the cumulative rate according to the use of induction therapy: rabbit antilymphocyte globulin (5-year rate 6.8%, 4/59), alemtuzumab (5-year rate 5.1%, 5/146). Treatment consisted of immunosuppression reduction and half received cidofovir. Eight of nine kidney allografts eventually failed, but all patients retained pancreatic allograft function.BKVN occurs in 5.6% of SPK recipients. There is no difference in the cumulative rate of BKVN between patients who received alemtuzumab or rabbit antilymphocyte globulin.

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