{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T06:17:27Z","timestamp":1788675447536,"version":"build-2803163510"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Nephrol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>BK polyomavirus (BKPyV)-associated nephropathy in kidney transplant recipients is an important cause of allograft dysfunction and premature allograft failure. Treatment options for BKPyV-DNAemia following kidney transplantation remain limited. Adjunctive pathogen adsorption devices such as the Seraph\u00ae 100 Microbind\u00ae Affinity Blood Filter (Seraph\u00ae 100) have previously been used for clearance of viruses, bacteria, and toxins in critical illness under FDA Emergency Use Authorization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case outline<\/jats:title>\n                    <jats:p>An 18-year-old recipient of a deceased donor kidney transplant developed severe BKPyV-DNAemia and biopsy-proven BKPyV-nephropathy refractory to reduced immunosuppression, antiviral therapy, and adjunctive intravenous immunoglobulin (IVIG). Given progressive allograft dysfunction, consideration was given to adjunctive extracorporeal therapies targeting BKPyV-DNAemia removal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Complications<\/jats:title>\n                    <jats:p>Despite multiple interventions including reduction of immunosuppression, cidofovir, leflunomide, and IVIG, BKPyV-DNAemia continued to worsen with levels reaching approximately 2 million copies\/mL by 7\u00a0months post-transplant. The patient developed de novo donor-specific antibodies and biopsy-proven antibody-mediated rejection concurrent with BKPyV-nephropathy and rising serum creatinine. Within 8\u00a0weeks of Seraph\u00ae treatment, BKPyV-DNA levels resolved to\u2009&lt;\u20095000 copies\/mL. During the subsequent 12-month follow-up period, her graft function stabilized with serum creatinine of 1.2\u20131.3\u00a0mg\/dL without proteinuria and stable class II DSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>List of relevant guidelines<\/jats:title>\n                    <jats:p>The Second International Consensus Guidelines on the Management of BK Polyomavirus in Kidney Transplantation (TTS 2024) [1]<\/jats:p>\n                    <jats:p>BK polyomavirus in solid organ transplantation \u2013 Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice (AST-IDCOP 2019) [2]<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00467-026-07419-y","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T05:44:36Z","timestamp":1782279876000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["First-time use of pathogen absorptive device in severe BK DNAemia\/BK polyomavirus-associated nephropathy post kidney transplantation"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8238-7939","authenticated-orcid":false,"given":"Kyle A.","family":"Merrill","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruthellen H.","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Axelrod","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brynna","family":"Van Wyk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyndsay A.","family":"Harshman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"7419_CR1","doi-asserted-by":"publisher","first-page":"1834","DOI":"10.1097\/TP.0000000000004976","volume":"108","author":"CN Kotton","year":"2024","unstructured":"Kotton CN, Kamar N, Wojciechowski D, Eder M, Hopfer H, Randhawa P, Sester M, Comoli P, Tedesco Silva H, Knoll G, Brennan DC, Trofe-Clark J, Pape L, Axelrod D, Kiberd B, Wong G, Hirsch HH (2024) The second international consensus guidelines on the management of BK polyomavirus in kidney transplantation. 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