{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T16:55:41Z","timestamp":1774544141268,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,3,1]],"date-time":"2017-03-01T00:00:00Z","timestamp":1488326400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>BK nephropathy (BKN) is a common cause of graft dysfunction following kidney transplantation. Minimization of immunosuppressive therapy remains the first line of therapy, but this may lead to rejection and graft loss. In some cases, despite lowering immunosuppression, BK infection can persist, leading to chronic damage and kidney failure. Currently, there is no specific anti\u2010BK viral therapy. Recent <jats:italic>in vitro<\/jats:italic> experiments have demonstrated a reduction in BK viral replication when infected cells are treated with the combination of Leflunomide and Everolimus. This study aims to explore the effect of this drugs combination on viral clearance and graft function in patients with persistent disease despite reduction in immunosuppression. We treated three patients with combination Leflunomide and Everolimus. Data on medical history, biochemical parameters and viral loads were collected. Significant improvement in viral loads was observed in two cases with resolution of viremia in another (Table\u00a01). Two recipients had preserved allograft function. The remaining graft was lost because of combination of obstruction and BKN. No adverse reactions such as bone marrow toxicity were observed. Combination of Leflunomide and Everolimus is safe and should be considered as a rescue therapy in treatment of BKN, especially in those who fail to clear this infection despite reduction of immunosuppressive therapy.<\/jats:p>","DOI":"10.1111\/nep.12948","type":"journal-article","created":{"date-parts":[[2017,3,1]],"date-time":"2017-03-01T08:01:51Z","timestamp":1488355311000},"page":"326-329","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Combination of Leflunomide and Everolimus for treatment of BK virus nephropathy"],"prefix":"10.1111","volume":"22","author":[{"given":"Juli","family":"Jaw","sequence":"first","affiliation":[{"name":"Department of Nephrology St Vincent's Hospital Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prue","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology St Vincent's Hospital Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Goodman","sequence":"additional","affiliation":[{"name":"Department of Nephrology St Vincent's Hospital Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,3]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/nep.12728"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2005.00742.x"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2009.06.049"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2369-14-207"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa020439"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3182007be2"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000053979"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200503173521125"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.tp.0000181149.76113.50"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03930907"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181bca422"},{"key":"e_1_2_5_13_1","first-page":"1","article-title":"Leflunomide with low\u2010dose Everolimus for treatment of Kaposi's sarcoma in a renal allograft recipient","volume":"0","author":"Basu G","year":"2011","journal-title":"Nephrol. Dial. Transplant."},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2006.01296.x"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2015.01.012"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2010.01384.x"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra993360"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181daaaf1"},{"key":"e_1_2_5_19_1","first-page":"393","article-title":"IVIG contains antibodies reactive with polyoma BK virus and may represent a therapeutic option for BK nephropathy","volume":"3","author":"Puliyanda D","year":"2003","journal-title":"Am. J. Transplant."}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fnep.12948","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.12948","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T08:26:25Z","timestamp":1695543985000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.12948"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3]]},"references-count":18,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2017,4]]}},"alternative-id":["10.1111\/nep.12948"],"URL":"https:\/\/doi.org\/10.1111\/nep.12948","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3]]},"assertion":[{"value":"2016-07-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-10-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-03-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}