Latent and productive polyomavirus infections of renal allografts: morphological, clinical, and pathophysiological aspects

Advances in Experimental Medicine and Biology
Volker NickeleitMichael J Mihatsch

Abstract

Polyomavirus allograft nephropathy, also termed BK virus nephropathy (BKN) after the main causative agent, the polyoma-BK-virus strain, is a major complication following kidney transplantation. BKN is the most common viral infection affecting the renal allograft with a reported prevalence of 1% up to 10%. It often leads to chronic allograft dysfunction and graft loss. BKN is most likely caused by the reactivation of latent BK viruses which, under sustained and intensive immunosuppression, enter a replicative/productive cycle. Viral disease, i.e., BKN, is typically limited to the kidney transplant. It is histologically defined by the presence of intranuclear viral inclusion bodies in epithelial cells and severe tubular injury. Virally induced tubular damage is the morphological correlate for allograft dysfunction. In this chapter, different variants of polyomavirus intranuclear inclusion bodies [types 1 through 4] and adjunct techniques [immunohistochemistry, in-situ hybridization, electron microscopy and polymerase chain reaction (PCR)] that are used for proper characterization of disease are described. Special emphasis is placed on the clinical and pathophysiological significance of different histological stages of BKN.

Citations

Sep 12, 2008·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Christian A SeemayerMichael J Mihatsch
Mar 16, 2017·Transplant International : Official Journal of the European Society for Organ Transplantation·Neerja AgrawalMichelle A Josephson
Jul 11, 2006·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·V Nickeleit
Nov 17, 2009·Transplant International : Official Journal of the European Society for Organ Transplantation·Eva KeményMichael J Mihatsch
Nov 22, 2013·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·C E TsengM Wang
Mar 20, 2009·Transplantation·Emilio RamosHans H Hirsch
Jan 14, 2016·Archives of Pathology & Laboratory Medicine·Megan L Troxell, Christian Lanciault
Jun 26, 2021·KI Reports·Miroslav SekulicGlen S Markowitz

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