BK-Virus and the Impact of Pre-Emptive Immunosuppression Reduction: 5-Year Results

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 In cases BK viremia, antimetabolite withdrawn for sustained minimized.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