UCLA Division of Nephrology, UCLA David Geffen School of Medicine, 1015 Gayley Avenue, Suite #220, Los Angeles, CA, 90024, USA.
J Nephrol. 2015 Dec;28(6):773-7. doi: 10.1007/s40620-015-0200-6. Epub 2015 Apr 25.
BK virus nephropathy is an important cause of kidney allograft failure. Retransplantation has been successfully performed for patients with previous allograft loss due to BK virus nephropathy; however, whether allograft nephrectomy and viral clearance are required prior to retransplantation is controversial. Some recent studies have suggested that retransplantion can be successfully achieved without allograft nephrectomy if viremia is cleared prior to retransplant. The only published experience of successful retransplantation in the presence of active viremia occurred in the presence of concomitant allograft nephrectomy of the failing kidney. In this report, we describe a case of successful repeat kidney transplant in a patient with high-grade BK viremia and fulminant hepatic failure without concomitant allograft nephrectomy performed under the setting of a simultaneous liver-kidney transplant.
BK 病毒肾病是导致肾移植失败的一个重要原因。对于因 BK 病毒肾病导致先前移植失败的患者，可以进行再次移植；然而，在再次移植前是否需要进行移植肾切除和清除病毒存在争议。一些最近的研究表明，如果在再次移植前清除病毒血症，可以在不进行移植肾切除的情况下成功进行再次移植。在活动性病毒血症存在的情况下成功再次移植的唯一已发表的经验是在同时进行衰竭肾脏的移植肾切除的情况下。在本报告中，我们描述了一例在同时进行肝-肾移植的情况下，在未同时进行移植肾切除的情况下，一名高等级 BK 病毒血症和暴发性肝衰竭患者成功进行重复肾移植的病例。
