{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:20:31Z","timestamp":1792686031614,"version":"4.5.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>BK virus\u2013associated nephropathy (BKVAN) remains an important risk factor for kidney graft loss. The current strategy to treat the BKVAN consists in reducing immunosuppressants. However, this strategy increases the risk of graft rejection, especially in highly sensitized patients or those with previous rejection episodes. Extracorporeal photopheresis (ECP) has been used for the treatment of T cell\u2013mediated disorders, such as solid organ rejection in cardiac, lung and hepatic transplantation, due to its immunotolerogenic effect. In addition, some data suggest that ECP might also have an immunogenic effect, generating an immune response against infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Herein we present a single-center case series of 13 patients with refractory histological-diagnosed BKVAN, where ECP was used after the failure of standard therapy. The cohort had a median age of 51 years (interquartile range 42\u201359), with 46% considered low immunological risk (cPRA 0%) and 54% high risk (cPRA &amp;gt;50%). ECP was initiated a median of 21.3 weeks (5.9\u201349.1) after BKVAN diagnosis, with patients receiving a median of 11 sessions (10\u201320).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After starting ECP, serum BK viral load significantly decreased by 55.3%, 95.9%, 99.7% and 99.9% at 3, 6, 12 and 18\u00a0months after ECP, respectively, while kidney function slowly decreased but at a lower rate than the historical group not treated with ECP, and no adverse events were observed. Despite the reduction in immunosuppression, only one patient experienced graft rejection during follow-up, with no major impact on graft function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings indicate that ECP may provide potential therapeutic benefits for BKVAN and could warrant further investigation in the context of kidney transplantation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ckj\/sfaf250","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T11:45:06Z","timestamp":1754567106000},"source":"Crossref","is-referenced-by-count":1,"title":["Extracorporeal photopheresis for refractory BK virus\u2013associated nephropathy in kidney transplantation"],"prefix":"10.1093","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0411-207X","authenticated-orcid":false,"given":"V\u00edctor J","family":"Escudero-Saiz","sequence":"first","affiliation":[{"name":"Hospital Cl\u00ednic Barcelona Department of Nephrology and Kidney Transplantation, , Catalonia ,","place":["Spain"]},{"name":"Laboratori Experimental de Nefrologia I Transplantament Renal (LENIT), Fundaci\u00f3 de Recerca Cl\u00ednic Barcelona \u2013 Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) , Barcelona ,","place":["Spain"]},{"name":"Redes de Investigaci\u00f3n Cooperativa Orientadas a Resultados en Salud (RICORS) , Madrid ,","place":["Spain"]},{"name":"Faculty of Medicine and Health Sciences, University of Barcelona Department of Medicine, , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1262-8072","authenticated-orcid":false,"given":"Marc","family":"Xipell","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic Barcelona Department of Nephrology and Kidney Transplantation, , Catalonia ,","place":["Spain"]},{"name":"Laboratori Experimental de Nefrologia I Transplantament Renal (LENIT), Fundaci\u00f3 de Recerca Cl\u00ednic Barcelona \u2013 Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) , Barcelona ,","place":["Spain"]},{"name":"Redes de Investigaci\u00f3n Cooperativa Orientadas a Resultados en Salud (RICORS) , Madrid ,","place":["Spain"]},{"name":"Faculty of Medicine and Health Sciences, University of Barcelona Department of Medicine, , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7565-2167","authenticated-orcid":false,"given":"\u00c1ngela","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic Barcelona Department of Nephrology and Kidney Transplantation, , Catalonia ,","place":["Spain"]},{"name":"Laboratori Experimental de Nefrologia I Transplantament Renal (LENIT), Fundaci\u00f3 de Recerca Cl\u00ednic Barcelona \u2013 Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) , Barcelona ,","place":["Spain"]},{"name":"Redes de Investigaci\u00f3n Cooperativa Orientadas a Resultados en Salud (RICORS) , Madrid ,","place":["Spain"]},{"name":"Faculty of Medicine and Health Sciences, University of Barcelona Department of Medicine, , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1027-7156","authenticated-orcid":false,"given":"Diana","family":"Rodr\u00edguez-Espinosa","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic Barcelona Department of Nephrology and Kidney Transplantation, , Catalonia ,","place":["Spain"]},{"name":"Laboratori Experimental de Nefrologia I Transplantament Renal (LENIT), Fundaci\u00f3 de Recerca Cl\u00ednic Barcelona \u2013 Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) , Barcelona ,","place":["Spain"]},{"name":"Redes de Investigaci\u00f3n Cooperativa Orientadas a Resultados en Salud (RICORS) , Madrid ,","place":["Spain"]},{"name":"Faculty of Medicine and Health Sciences, University of Barcelona Department of Medicine, , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judit","family":"Cacho","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic Barcelona Department of Nephrology and Kidney Transplantation, , Catalonia ,","place":["Spain"]},{"name":"Faculty of Medicine and Health Sciences, University of Barcelona Department of Medicine, , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1100-5758","authenticated-orcid":false,"given":"Carolt","family":"Arana","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic Barcelona Department of Nephrology and Kidney Transplantation, , Catalonia ,","place":["Spain"]},{"name":"Laboratori Experimental de Nefrologia I Transplantament Renal (LENIT), Fundaci\u00f3 de Recerca Cl\u00ednic Barcelona \u2013 Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) , Barcelona ,","place":["Spain"]},{"name":"Redes de Investigaci\u00f3n Cooperativa Orientadas a Resultados en Salud (RICORS) , Madrid ,","place":["Spain"]},{"name":"Faculty of Medicine and Health Sciences, University of Barcelona Department of Medicine, , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gast\u00f3n J","family":"Pi\u00f1eiro","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic Barcelona Department of Nephrology and Kidney Transplantation, , Catalonia ,","place":["Spain"]},{"name":"Laboratori Experimental de Nefrologia I Transplantament Renal (LENIT), Fundaci\u00f3 de Recerca Cl\u00ednic Barcelona \u2013 Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) , Barcelona ,","place":["Spain"]},{"name":"Redes de Investigaci\u00f3n Cooperativa Orientadas a 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,","place":["Spain"]},{"name":"Hospital Cl\u00ednic Barcelona Department of Pathology, , Catalonia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Charry","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, University of Barcelona Department of Medicine, , Barcelona ,","place":["Spain"]},{"name":"Hospital Cl\u00ednic Barcelona Apheresis Unit, Department of Hemotherapy and Hemostasis, , Catalonia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5445-4508","authenticated-orcid":false,"given":"Joan","family":"Cid","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, University of Barcelona Department of Medicine, , Barcelona ,","place":["Spain"]},{"name":"Hospital Cl\u00ednic Barcelona Apheresis Unit, Department of Hemotherapy and Hemostasis, , Catalonia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Oppenheimer","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic Barcelona Department of Nephrology and Kidney Transplantation, , Catalonia ,","place":["Spain"]},{"name":"Laboratori Experimental de Nefrologia I Transplantament Renal (LENIT), Fundaci\u00f3 de Recerca Cl\u00ednic Barcelona \u2013 Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) , Barcelona ,","place":["Spain"]},{"name":"Redes de Investigaci\u00f3n Cooperativa Orientadas a Resultados en Salud (RICORS) , Madrid ,","place":["Spain"]},{"name":"Faculty of Medicine and Health Sciences, University of Barcelona Department of Medicine, , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Bodro","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, University of Barcelona Department of 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