Our Summary

The BK virus (BKV) is known to cause problems in patients who have received kidney transplants or stem cell transplants. In the late 90s, BKV related kidney disease (known as BKVAN) became a common issue, likely due to the use of powerful drugs that suppress the immune system. At its worst, BKVAN occurred in up to 5% of kidney transplant patients, with up to 70% of these cases resulting in the transplant failing. However, thanks to the implementation of effective screening and treatment methods, BKV is no longer a common cause of transplant failure. In fact, the reported failure rate of transplants due to BKV is now only between 0% and 5%. This paper provides a brief overview of the BK virus, including its virology, how it spreads, how it is diagnosed, and how it is managed.

FAQs

  1. What is BK virus (BKV) and how can it affect kidney transplant recipients?
  2. What is BKV-associated nephropathy (BKVAN) and how common is this complication in kidney transplant recipients?
  3. What are the effective screening and treatment strategies that have reduced BKV as a common cause of graft failure?

Doctor’s Tip

A doctor might tell a patient undergoing a pancreas transplant to be aware of the risk of infections such as BK virus, which can affect the function of the new pancreas. It is important to follow proper screening and treatment strategies to prevent complications and ensure the success of the transplant.

Suitable For

Patients who are typically recommended for a pancreas transplant include those with type 1 diabetes who have severe complications such as kidney failure, nerve damage, or vision problems that are not well controlled with insulin therapy. Candidates for pancreas transplant may also have severe hypoglycemia unawareness, frequent episodes of severe low blood sugar, or difficulty managing their diabetes due to other medical conditions. Additionally, patients who have had a previous kidney transplant and are in need of a pancreas transplant to improve overall health and quality of life may also be recommended for the procedure.

Timeline

Before pancreas transplant:

  1. Patient is diagnosed with type 1 diabetes and experiences symptoms such as frequent urination, increased thirst, weight loss, and fatigue.
  2. Patient undergoes comprehensive evaluation and assessment to determine eligibility for pancreas transplant, including medical history, physical examination, blood tests, imaging studies, and psychological evaluation.
  3. Patient is placed on the transplant waiting list and waits for a suitable donor pancreas to become available.
  4. Patient receives pre-transplant education and counseling on the transplant procedure, risks, benefits, and post-transplant care.

After pancreas transplant:

  1. Patient undergoes the pancreas transplant surgery, which involves removing the diseased pancreas and replacing it with a healthy donor pancreas.
  2. Patient is closely monitored in the hospital for complications such as infection, rejection, and organ dysfunction.
  3. Patient receives immunosuppressive medications to prevent rejection of the transplanted pancreas.
  4. Patient undergoes regular follow-up visits with healthcare providers to monitor the function of the transplanted pancreas, adjust medications, and address any complications.
  5. Patient may experience improvements in blood sugar control, insulin independence, and overall quality of life following a successful pancreas transplant.

What to Ask Your Doctor

  1. What is the risk of developing BKV-associated nephropathy after a pancreas transplant?
  2. What screening tests are available to detect BK virus in transplant recipients?
  3. How often will I need to be monitored for BK virus after the transplant?
  4. What are the symptoms of BKV-associated nephropathy and when should I seek medical attention?
  5. What treatment options are available if I develop BKV-associated nephropathy?
  6. How does my current immunosuppressive medication regimen affect my risk of developing BKV-associated nephropathy?
  7. Are there any lifestyle changes or precautions I should take to reduce my risk of BK virus infection?
  8. How successful are current treatment strategies for BKV-associated nephropathy in pancreas transplant recipients?
  9. Are there any long-term complications or risks associated with BKV infection after a pancreas transplant?
  10. How can I best protect my transplanted pancreas from potential complications related to BK virus?

Reference

Authors: Elfadawy N, Yamada M, Sarabu N. Journal: Infect Dis Clin North Am. 2018 Sep;32(3):599-613. doi: 10.1016/j.idc.2018.04.009. PMID: 30146025