Clinical Efficacy of Intravenous Immunoglobulin for BK Polyomavirus-Associated Nephropathy After Living Kidney Transplantation

Soichi Matsumura,1 Taigo Kato,1,2 Ayumu Taniguchi,1 Masataka Kawamura,1 Shigeaki Nakazawa,1 Tomoko Namba-Hamano,3 Toyofumi Abe,1 Norio Nonomura,1 Ryoichi Imamura1 1Department of Urology, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan; 2Department of Urological Immuno-Oncology, O...

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Autores principales:	Matsumura S, Kato T, Taniguchi A, Kawamura M, Nakazawa S, Namba-Hamano T, Abe T, Nonomura N, Imamura R
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	bk virus bk virus nephropathy intravenous immunoglobulin kidney transplantation polyomavirus nephropathy classification Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/a0505d58272c4eec9399cb8113bd1e31
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spelling	oai:doaj.org-article:a0505d58272c4eec9399cb8113bd1e312021-12-02T12:30:05ZClinical Efficacy of Intravenous Immunoglobulin for BK Polyomavirus-Associated Nephropathy After Living Kidney Transplantation1178-203Xhttps://doaj.org/article/a0505d58272c4eec9399cb8113bd1e312020-10-01T00:00:00Zhttps://www.dovepress.com/clinical-efficacy-of-intravenous-immunoglobulin-for-bk-polyomavirus-as-peer-reviewed-article-TCRMhttps://doaj.org/toc/1178-203XSoichi Matsumura,1 Taigo Kato,1,2 Ayumu Taniguchi,1 Masataka Kawamura,1 Shigeaki Nakazawa,1 Tomoko Namba-Hamano,3 Toyofumi Abe,1 Norio Nonomura,1 Ryoichi Imamura1 1Department of Urology, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan; 2Department of Urological Immuno-Oncology, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan; 3Department of Nephrology, Osaka University Graduate School of Medicine, Osaka 565-0871, JapanCorrespondence: Taigo KatoDepartment of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, JapanTel +81-6-6879-3531Fax +81-6-6879-3534Email kato@uro.med.oaska-u.ac.jpPurpose: BK polyomavirus (BKPyV)-associated nephropathy (BKPyVAN) is one of the most difficult infections to be treated after kidney transplantation. Although patients with BKPyVAN usually received a reduction of immunosuppressive agents, the majority of these patients undergo the loss of the graft kidney without any effective treatment afterward. Therefore, development of more effective therapy for BKPyVAN is eagerly expected.Patients and Methods: Among patients who underwent a kidney transplantation between January 2016 and April 2019 at our hospital, there were five cases of BKPyVAN. After the initial diagnosis, all patients discontinued administration of mycophenolate mofetil (MMF), which was not enough to diminish decoy cells in urine cytology test. Therefore, all patients received additional intravenous immunoglobulin (IVIG) (100 mg/kg/day) therapy for five days and were evaluated for the therapeutic effect of IVIG with immunohistochemical examination using re-biopsy samples of the graft kidney.Results: After IVIG therapy, 2 cases showed negative decoy cells in urine and 3 cases showed a drastic decrease of plasma BK virus load. Importantly, simian virus (SV) 40 large T antigens diminished after IVIG administration in all cases, which degraded polyomavirus nephropathy classification.Conclusion: Although it is difficult to treat BKPyVAN after kidney transplant, IVIG therapy was considered to a promising treatment to improve severity of BKPyVAN especially in cases that dose reduction of immunosuppressive agents was ineffective.Keywords: BK virus, BK virus nephropathy, intravenous immunoglobulin; IVIG, kidney transplantation, polyomavirus nephropathy classificationMatsumura SKato TTaniguchi AKawamura MNakazawa SNamba-Hamano TAbe TNonomura NImamura RDove Medical Pressarticlebk virusbk virus nephropathyintravenous immunoglobulinkidney transplantationpolyomavirus nephropathy classificationTherapeutics. PharmacologyRM1-950ENTherapeutics and Clinical Risk Management, Vol Volume 16, Pp 947-952 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	bk virus bk virus nephropathy intravenous immunoglobulin kidney transplantation polyomavirus nephropathy classification Therapeutics. Pharmacology RM1-950
spellingShingle	bk virus bk virus nephropathy intravenous immunoglobulin kidney transplantation polyomavirus nephropathy classification Therapeutics. Pharmacology RM1-950 Matsumura S Kato T Taniguchi A Kawamura M Nakazawa S Namba-Hamano T Abe T Nonomura N Imamura R Clinical Efficacy of Intravenous Immunoglobulin for BK Polyomavirus-Associated Nephropathy After Living Kidney Transplantation
description	Soichi Matsumura,1 Taigo Kato,1,2 Ayumu Taniguchi,1 Masataka Kawamura,1 Shigeaki Nakazawa,1 Tomoko Namba-Hamano,3 Toyofumi Abe,1 Norio Nonomura,1 Ryoichi Imamura1 1Department of Urology, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan; 2Department of Urological Immuno-Oncology, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan; 3Department of Nephrology, Osaka University Graduate School of Medicine, Osaka 565-0871, JapanCorrespondence: Taigo KatoDepartment of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, JapanTel +81-6-6879-3531Fax +81-6-6879-3534Email kato@uro.med.oaska-u.ac.jpPurpose: BK polyomavirus (BKPyV)-associated nephropathy (BKPyVAN) is one of the most difficult infections to be treated after kidney transplantation. Although patients with BKPyVAN usually received a reduction of immunosuppressive agents, the majority of these patients undergo the loss of the graft kidney without any effective treatment afterward. Therefore, development of more effective therapy for BKPyVAN is eagerly expected.Patients and Methods: Among patients who underwent a kidney transplantation between January 2016 and April 2019 at our hospital, there were five cases of BKPyVAN. After the initial diagnosis, all patients discontinued administration of mycophenolate mofetil (MMF), which was not enough to diminish decoy cells in urine cytology test. Therefore, all patients received additional intravenous immunoglobulin (IVIG) (100 mg/kg/day) therapy for five days and were evaluated for the therapeutic effect of IVIG with immunohistochemical examination using re-biopsy samples of the graft kidney.Results: After IVIG therapy, 2 cases showed negative decoy cells in urine and 3 cases showed a drastic decrease of plasma BK virus load. Importantly, simian virus (SV) 40 large T antigens diminished after IVIG administration in all cases, which degraded polyomavirus nephropathy classification.Conclusion: Although it is difficult to treat BKPyVAN after kidney transplant, IVIG therapy was considered to a promising treatment to improve severity of BKPyVAN especially in cases that dose reduction of immunosuppressive agents was ineffective.Keywords: BK virus, BK virus nephropathy, intravenous immunoglobulin; IVIG, kidney transplantation, polyomavirus nephropathy classification
format	article
author	Matsumura S Kato T Taniguchi A Kawamura M Nakazawa S Namba-Hamano T Abe T Nonomura N Imamura R
author_facet	Matsumura S Kato T Taniguchi A Kawamura M Nakazawa S Namba-Hamano T Abe T Nonomura N Imamura R
author_sort	Matsumura S
title	Clinical Efficacy of Intravenous Immunoglobulin for BK Polyomavirus-Associated Nephropathy After Living Kidney Transplantation
title_short	Clinical Efficacy of Intravenous Immunoglobulin for BK Polyomavirus-Associated Nephropathy After Living Kidney Transplantation
title_full	Clinical Efficacy of Intravenous Immunoglobulin for BK Polyomavirus-Associated Nephropathy After Living Kidney Transplantation
title_fullStr	Clinical Efficacy of Intravenous Immunoglobulin for BK Polyomavirus-Associated Nephropathy After Living Kidney Transplantation
title_full_unstemmed	Clinical Efficacy of Intravenous Immunoglobulin for BK Polyomavirus-Associated Nephropathy After Living Kidney Transplantation
title_sort	clinical efficacy of intravenous immunoglobulin for bk polyomavirus-associated nephropathy after living kidney transplantation
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/a0505d58272c4eec9399cb8113bd1e31
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Clinical Efficacy of Intravenous Immunoglobulin for BK Polyomavirus-Associated Nephropathy After Living Kidney Transplantation

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