Summary of what I read ... the salient points of BKVIN

1)Reactivation of BK virus is a cause of allograft dysfunction and can lead to allograft loss.

2) All renal transplant recipients should be screened for BK virus replication early in the transplant course or when allograft dysfunction is noted.

3) Definitive diagnosis of BKVIN requires allograft biopsy. Not urine, not serum.

4) If BKVIN and concurrent acute rejection is diagnosed, antirejection treatment should be considered, coupled with subsequently reducing immunosuppression.

5) Reduction of immunosuppression has been associated with clearance of viremia in asymptomatic patients.

6) Leflunomide may be associated with clearance of viremia and stabilization of renal function.

7) Cidofovir at low doses (0.25–0.33 mg/kg intravenously biweekly) without probenicid could be considered for refractory cases.

8) Retransplantation after renal allograft loss to BKVIN remains a treatment option for patients who have cleared viremia.