Yi Stephanie G, Knight Richard J, Lunsford Keri E
aWeill Cornell Medical College, Department of Surgery, J.C. Walter Jr. Center for Transplantation, Houston Methodist Hospital bImmunobiology and Transplant Science Center, Department of Surgery, Houston Methodist Research Institute, Houston, Texas, USA.
Curr Opin Organ Transplant. 2017 Aug;22(4):320-327. doi: 10.1097/MOT.0000000000000429.
BK virus is a significant risk factor for kidney allograft dysfunction and loss among renal transplant recipients. Currently, there is no proven effective treatment except for the reduction of immunosuppression. In this review, we discuss diagnostic challenges and current treatment options for BK in kidney transplant recipients.
Antiviral and antibiotic therapies have been employed for BK viraemia with variable efficacy. In addition, novel therapeutic regimens such as adoptive transfer of targeted T cells have been described as possible treatment options for recipients with BK nephropathy. BK can also be seen in the native kidneys of pancreas, heart, lung and liver transplant recipients, suggesting that BK screening measures should be employed to other solid organ transplant recipients.
Early screening for BK combined with reduction of immunosuppression remains the mainstay of treatment for BK viraemia. New therapeutic advances demonstrate promise in vitro; however, the in-vivo efficacy will be demonstrated by future studies.
BK病毒是肾移植受者肾移植功能障碍和移植肾丢失的重要危险因素。目前，除了减少免疫抑制外，尚无经证实有效的治疗方法。在本综述中，我们讨论了肾移植受者BK病毒感染的诊断挑战和当前的治疗选择。
抗病毒和抗生素疗法已用于治疗BK病毒血症，疗效各异。此外，诸如靶向T细胞的过继转移等新型治疗方案已被描述为BK肾病受者可能的治疗选择。BK病毒也可见于胰腺、心脏、肺和肝移植受者的原生肾中，这表明BK病毒筛查措施应应用于其他实体器官移植受者。
早期筛查BK病毒并结合减少免疫抑制仍然是BK病毒血症治疗的主要方法。新的治疗进展在体外显示出前景；然而，其体内疗效将由未来的研究来证实。
