关键词:

BK 病毒 , 排斥反应 , 免疫抑制剂 , 移植肾损害

Abstract:

Objective To analyze the difference of immunosuppressant regimen adjustment between renal transplant recipients with pathological results of rejection and BK polyomavirus nephropathy. Methods Thirty two cases were selected from the Kidney Transplantation Department of the First Affiliated Hospital of Xi'an Jiaotong University from June 2019 to May 2024，who tested positive for BK in blood and had subsequent pathological results of rejection and BK virus nephropathy in transplanted kidneys. Based on the pathological results of transplantedkidneys，they were divided into a rejection group（21 cases）and a BK virus nephropathy group（11 cases）. Theclinical data such as the discovery time and value of plasma BK，adjustment of immunosuppressant regimen， immunosuppressant blood concentration，pathological diagnosis time and results，BK negative time，and transplanted kidney function status were collected and analyzed. Results The dosage of mizoribine in the rejection group（median was 100 mg/d）was significantly lower than that in the BK polyomavirus nephropathy group（median was 150 mg/d）.The time from plasma BK detected to pathological diagnosis established was significantly longer than that in the BKpolyomavirus nephropathy group（P ＜ 0.05）. There was no significant difference in loss of transplanted kidney （P ＞ 0.05）. Conclusion For kidney transplant recipients with persistently plasma BK，the incidence of rejection reactions is higher after adjusting the immunosuppressive regimen. Rejection caused by insufficient immunosuppressive dosage and delayed pathological diagnosis should be avoided to reduce the occurrence of transplanted kidney damage. 

Key words:

BK polyomavirus, Rejection, Immunosuppressant, Transplanted kidney damage