Sener Alp, House Andrew A, Jevnikar Anthony M, Boudville Neil, McAlister Vivian C, Muirhead Norman, Rehman Faisal, Luke Patrick P W
Department of Surgery, Division of Urology, London Health Sciences Center, London, Ontario, Canada.
Transplantation. 2006 Jan 15;81(1):117-20. doi: 10.1097/01.tp.0000181096.14257.c2.
BK virus associated nephropathy (BKVAN) has emerged as an important cause of renal allograft dysfunction and graft loss. Although several treatment strategies have been proposed, the rate of graft loss remains high. We studied the outcome of renal transplant patients with BKVAN treated with IVIG. After 11.4 +/- 3.9 months (mean +/- SEM) from the time of transplantation, 8 renal allograft recipients were diagnosed with BKVAN. In addition to a reduction of immunosuppressive therapy, patients received 2 g/kg IVIG. After a mean follow-up of 15 months, all except one patient are currently off dialysis. In summary, after IVIG therapy, 88% of patients still have functioning grafts, although renal function continues to be impaired. The benefit of concomitant IVIG and reduction of immunosuppressive therapy in BKVAN needs to be further addressed in randomized, multicentered trials.
BK病毒相关性肾病(BKVAN)已成为肾移植功能障碍和移植肾丢失的重要原因。尽管已提出多种治疗策略,但移植肾丢失率仍然很高。我们研究了接受静脉注射免疫球蛋白(IVIG)治疗的BKVAN肾移植患者的预后。移植后11.4±3.9个月(平均±标准误),8例肾移植受者被诊断为BKVAN。除了减少免疫抑制治疗外,患者还接受了2 g/kg的IVIG治疗。平均随访15个月后,除1例患者外,其他所有患者目前均已停止透析。总之,IVIG治疗后,88%的患者移植肾仍有功能,尽管肾功能仍有损害。IVIG与减少免疫抑制治疗联合应用于BKVAN的益处需要在随机、多中心试验中进一步探讨。