Successful prevention of BK-polyomavirus nephropathy using extracorporeal photopheresis for immunosuppression minimisation following severe BK polyomavirus replication after kidney transplantation in a double lung transplant recipient, a case report

BMC Nephrol. 2024 Oct 18;25(1):363. doi: 10.1186/s12882-024-03788-4.

Abstract

Background: BK-polyomavirus (BKpyV) nephropathy (BKVN) is associated with end-stage kidney disease in kidney and non-kidney solid organ transplantation, with no curative treatment.

Case presentation: A 45-year-old woman with a past medical history of double lung transplantation subsequently developed end-stage kidney disease, of undetermined origin. One month after receiving a kidney transplant, a diagnosis of early BKVN was suspected, and in retrospect was a reasonable cause for the loss of her native kidneys. Minimisation of immunosuppression, achieved through extracorporeal photopheresis, allowed clearance of BKpyV and so prevented nephropathy. Both lung and kidney grafts had a satisfactory and stable function after one year of follow-up, with no rejection.

Conclusions: Extracorporeal photopheresis may have facilitated minimisation of immunosuppression and BKpyV clearance without lung allograft rejection.

Keywords: BK-polyomavirus; Case report; Extracorporeal photopheresis; Kidney transplant; Lung transplant; Minimization.

Publication types

  • Case Reports

MeSH terms

  • BK Virus*
  • Female
  • Humans
  • Immunosuppression Therapy
  • Kidney Diseases / therapy
  • Kidney Failure, Chronic / surgery
  • Kidney Failure, Chronic / therapy
  • Kidney Transplantation*
  • Lung Transplantation*
  • Middle Aged
  • Photopheresis* / methods
  • Polyomavirus Infections*
  • Postoperative Complications
  • Tumor Virus Infections*
  • Virus Replication