Infection: Edited by Minh-Hong NguyenBK viral disease in renal transplantationCannon, Robert M.; Ouseph, Rosemary; Jones, Christopher M.; Hughes, Michael G.; Eng, Mary; Marvin, Michael R.Author Information Division of Transplantation, Department of Surgery, University of Louisville, Louisville, Kentucky, USA Correspondence to Michael R. Marvin, MD, Jewish Hospital Transplant Center, 3rd Floor, 200 Abraham Flexner Way, Louisville, KY 40202, USATel: +1 502 587 2524; fax: +1 502 587 4323; e-mail: Michael.email@example.com Current Opinion in Organ Transplantation: December 2011 - Volume 16 - Issue 6 - p 576-579 doi: 10.1097/MOT.0b013e32834cd666 Buy Metrics Abstract Purpose of review BK virus is one of the most frequent causes of graft loss after renal transplantation, with BK virus-associated nephropathy occurring in roughly 8% of patients, and graft loss rates reported as high as 50%. This review is meant to highlight the literature on BK viral disease following renal transplantation published in the most recent year. Recent findings Prevention of BK virus-associated graft loss requires early diagnosis of BK viral replication, which is best achieved by screening for BK viral DNA in the blood. Screening intervals more frequently than the currently recommended 3 months appear to offer increased efficacy. Reduction in immunosuppression remains the mainstay for treatment of BK viral disease, with consideration given to antiviral drug therapy with leflunomide. Acute rejection may be minimized by a short course of intravenous immunoglobulin. Sirolimus appears to be a promising addition to the therapeutic armamentarium. For patients requiring re-transplantation after BK virus-associated graft loss, viral clearance from the bloodstream prior to re-transplantation should be achieved to attain optimal results. Summary BK virus is a major pathogen affecting renal allografts, although intensive surveillance and targeted dose reduction in immunosuppression with the consideration of additional antiviral drug therapy can minimize graft loss resulting from infection. © 2011 Lippincott Williams & Wilkins, Inc.