{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T05:50:11Z","timestamp":1761630611834},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,3,26]],"date-time":"2012-03-26T00:00:00Z","timestamp":1332720000000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2012,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>More than half of the simultaneous pancreas kidney transplant (<jats:styled-content style=\"fixed-case\">SPK<\/jats:styled-content>) patients afflicted with <jats:styled-content style=\"fixed-case\">BK<\/jats:styled-content> virus nephropathy (<jats:styled-content style=\"fixed-case\">BKVN<\/jats:styled-content>) lose their kidney allograft. Fear of pancreatic rejection limits the ability to reduce immunosuppression; this may result in inadequate treatment of <jats:styled-content style=\"fixed-case\">BKVN<\/jats:styled-content>.<\/jats:p><jats:p>This single\u2010center retrospective review included 138 <jats:styled-content style=\"fixed-case\">SPK<\/jats:styled-content> patients who underwent periodic <jats:styled-content style=\"fixed-case\">BKV<\/jats:styled-content> screening and were managed with <jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content> reduction alone as a treatment of choice for <jats:styled-content style=\"fixed-case\">BKVN<\/jats:styled-content>.<\/jats:p><jats:p>All patients underwent rabbit anti\u2010thymocyte globulin (<jats:styled-content style=\"fixed-case\">rATG<\/jats:styled-content>) induction and were maintained on tacrolimus\/sirolimus or mycophenolate. The incidence of <jats:styled-content style=\"fixed-case\">BKVN<\/jats:styled-content> was 4.4%. <jats:styled-content style=\"fixed-case\">BKVN<\/jats:styled-content> was diagnosed at a median of 11\u00a0months; mean serum creatinine 2.1\u00a0mg\/dL and the geometric mean <jats:styled-content style=\"fixed-case\">BK<\/jats:styled-content> serum viral load at diagnosis 1\u00a0758\u00a0000 <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> copies\/mL. Median time to <jats:styled-content style=\"fixed-case\">BKV<\/jats:styled-content> clearance was 5.6\u00a0months; there was 96% reduction in the mycophenolate dose, 100% reduction in sirolimus, and 40% reduction in the tacrolimus blood level at <jats:styled-content style=\"fixed-case\">BKVN<\/jats:styled-content> clearance. No <jats:styled-content style=\"fixed-case\">BKVN<\/jats:styled-content>\u2010related kidney failure was noted, and patients retained excellent kidney and pancreatic allograft function till last follow\u2010up (43\u00a0months).<\/jats:p><jats:p><jats:styled-content style=\"fixed-case\">BKVN<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">SPK<\/jats:styled-content> is a potentially preventable cause of end\u2010stage kidney disease, and <jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content> reduction alone is an acceptable treatment modality in <jats:styled-content style=\"fixed-case\">SPK<\/jats:styled-content> without a higher risk of kidney\/pancreas allograft loss as long as close monitoring can be 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