Zusammenfassung der 2. internationalen Konsensusleitlinie zum Management von BK-Polyomavirus bei Patienten nach Nierentransplantation

This summary of the 2nd international consensus guidelines on the management of BK polyomavirus (BKV) in patients after kidney transplantation provides an overview of the essential contents. For more details and comprehensive contents, we refer to the corresponding guidelines. In addition to changes in terminologies, word definitions and an introduction to the topic, diagnostic strategies including test options and studies on therapeutic approaches were compared as much as possible and indications for a biopsy were discussed. The key recommendations are as follows: (1) regular screening for BK virus viruria or decoy cells in urine or BK virus DNAemia in plasma, is generally considered to be meaningful. (2) The indication for a biopsy is as a rule the higher grade detection of BK virus DNAemia in plasma with worsening renal function. When there is no increased immunological risk, reduction of immunosuppression can be considered even without a biopsy. (3) The approach in cases of detection of BK virus DNAemia after transplantation is as before, firstly reduction of immunosuppression. The options are a reduction of mycophenolate mofetil or calcineurin inhibitor or both. Switching to immunosuppression with a mechanistic target of rapamycin (mTOR) inhibitor can be beneficial in cases of recurrence. (4) There are few studies on pediatric patients, therefore, they are treated in the same way as adults.