Dataset Information

BK-virus and the impact of pre-emptive immunosuppression reduction: 5-year results.

ABSTRACT: A 1-year, single-center, randomized trial demonstrated that the calcineurin inhibitor or adjuvant immunosuppression, independently, does not affect BK-viruria or viremia and that monitoring and pre-emptive withdrawal of immunosuppression was associated with resolution of BK-viremia and absence of clinical BK-nephropathy without acute rejection or graft loss. A retrospective 5-year review of this trial was conducted. In cases of BK viremia, the antimetabolite was withdrawn and for sustained viremia, the calcineurin inhibitor was minimized. Five-year follow-up was available on 97% of patients. Overall 5-year patient survival was 91% and graft survival was 84%. There were no differences in patient-survival by immunosuppressive regimen or presence of BK-viremia. Immunosuppression and viremia did not influence graft survival. Acute rejection occurred in 12% by 5-years after transplant, was less common with tacrolimus versus cyclosporine (9% vs. 18%; p = 0.082), and was lowest with the tacrolimus-azathioprine regimen (5%, p = 0.127). Tacrolimus was associated with better renal function at 5-years (eGFR 63 FK vs. 52 CsA mL/min, p = 0.001). Minimization of immunosuppression upon detection of BK-viremia was associated with excellent graft survival at 5-years, low rejection rates and excellent renal function. It is a safe, short and long-term strategy that resulted in freedom from clinically evident BK-virus nephropathy.

SUBMITTER: Hardinger KL

PROVIDER: S-EPMC3188431 | biostudies-literature | 2010 Feb

REPOSITORIES: biostudies-literature

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BK-virus and the impact of pre-emptive immunosuppression reduction: 5-year results.

Hardinger K L KL Koch M J MJ Bohl D J DJ Storch G A GA Brennan D C DC

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons 20100105 2

A 1-year, single-center, randomized trial demonstrated that the calcineurin inhibitor or adjuvant immunosuppression, independently, does not affect BK-viruria or viremia and that monitoring and pre-emptive withdrawal of immunosuppression was associated with resolution of BK-viremia and absence of clinical BK-nephropathy without acute rejection or graft loss. A retrospective 5-year review of this trial was conducted. In cases of BK viremia, the antimetabolite was withdrawn and for sustained virem ...[more]

PMID: 20055811

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Dataset Information

BK-virus and the impact of pre-emptive immunosuppression reduction: 5-year results.

Publications

BK-virus and the impact of pre-emptive immunosuppression reduction: 5-year results.

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