Korean J Nephrol.  2009 May;28(3):211-218.

Leflunomide Treatment in BK Virus Associated Nephropathy after Renal Transplantation

• Son YK
• Oh JS
• Oh HJ
• Shin YH
• Kim JK
• Jeong HJ

Abstract

PURPOSE:BK virus associated nephropathy (BKVAN) affects 1-10% of kidney transplant (KT) patients and it produces a progressive destruction of allograft. Reducing immunosuppression is the only way to save the graft, while it needs tight monitoring of the graft rejection and graft survival is poorer in advanced case. Leflunomide has immunosuppressive effect and also antiviral activity. Addition of leflunomide may improve BK virus clearance and graft survival.
METHODS
6 KT patients with biopsy proven BKVAN (Histological pattern B) were treated with leflunomide and reduced immunosuppression. All patients were monitored with serial determination of viral load in blood and graft function.
RESULTS
BKVAN was diagnosed at 14 months (7-28) post transplant, at that time median serum creatinine concentration was 2.8 mg/dL (1.8-3.6). 12.5 months (6-16) later of leflunomide treatment, median serum creatinine was 2.3 mg/dL and no graft loss was found.
CONCLUSION
Leflunomide therapy with reduced immunosuppression may be effective in the treatment for BKVAN.

Keyword

BK virus; Kidney transplantation; Leflunomide

MeSH Terms

Biopsy
BK Virus
Creatinine
Graft Rejection
Graft Survival
Humans
Immunosuppression
Isoxazoles
Kidney
Kidney Transplantation
Transplantation, Homologous
Transplants
Viral Load
Viruses
Creatinine
Isoxazoles