Native BK virus nephropathy in lung transplant: a case report and literature review

Classically described in renal allografts, BK virus nephropathy is increasingly recognized in native kidneys of other non-renal solid organ transplants. We discuss a 68-year-old woman with a history of bilateral lung transplant referred for worsening renal function, confirmed to have BK virus nephropathy by biopsy with a serum BK virus polymerase chain reaction of over 59 million copies/mL. She was managed with a reduction in immunosuppression and intravenous cidofovir with no improvement in her clinical parameters. The seven prior reported cases of polyoma virus nephropathy in lung transplant recipients are reviewed, and the challenges of screening and management are discussed.

Automated summary

BK virus nephropathy, classically described in renal allografts, is increasingly recognized in native kidneys of non-renal solid organ transplants. This article discusses a 68-year-old woman with a history of bilateral lung transplant who was diagnosed with BK virus nephropathy. Despite treatment with reduced immunosuppression and intravenous cidofovir, the patient's clinical parameters did not improve. The challenges of screening and management in lung transplant recipients with polyoma virus nephropathy are also reviewed.