Bk polyomavirus nephropathy in kidney transplantation: Balancing rejection and infection

Chia Lin Shen, Bo Sheng Wu, Tse Jen Lien, An Hang Yang, Chih Yu Yang*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

29 Scopus citations


BK polyomavirus nephropathy (BKVN) and allograft rejection are two closely-associated diseases on opposite ends of the immune scale in kidney transplant recipients. The principle of balancing the immune system remains the mainstay of therapeutic strategy. While patient outcomes can be improved through screening, risk factors identification, and rapid reduction of immunosuppressants, a lack of standard curative therapy is the primary concern during clinical practice. Additionally, difficulty in pathological differential diagnosis and clinicopathology’s dissociation pose problems for a definite diagnosis. This article discusses the delicate evaluation needed to optimize immunosuppression and reviews recent advances in molecular diagnosis and immunological therapy for BKVN patients. New biomarkers for BKVN diagnosis are under development. For example, measurement of virus-specific T cell level may play a role in steering immunosuppressants. The development of cellular therapy may provide prevention, even a cure, for BKVN, a complex post-transplant complication.

Original languageEnglish
Article number487
Issue number3
StatePublished - Mar 2021


  • Acute rejection
  • BK polyomavirus nephropathy
  • Immunosuppressants
  • Kidney transplant
  • Tacrolimus


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