부산대학교 도서관

Background: Since the discovery of BK Virus (BKV) in 1971, it became a growing challenge in the renal transplant field. Many hypotheses over the latest years have been made to justify the increased risk of acquiring BKV infection post-renal transplantation. Excessive immunosuppression remains the primary risk factor. Risk factors such as older recipients, male gender, prolonged cold ischemia time, ureteric stent insertion, degree of HLA mismatching and others have all been linked as additional risks for acquiring BKV infection. Nevertheless, the current literature on risk factors are inconclusive and no single identifiable risk factor can determine recipients who at risk. Objective: The objective of this review is to delineate and contemplate the potential risk factors published in the literature and leads to BKV nephropathy. Methodology: For this review, a variety of sources were utilised including EMBASE, Scopus, PubMed/Medline database and Google Scholar for observational studies on probable risk factors predisposing to BK viremia and/or nephropathy. Results: almost 22 distinctive risk factors were identified. Discussion: Over immunosuppression remains the major risk factor for acquiring BKV infection post-renal transplant, though it is uncertain whether the occurrence of BKVN (BKV Nephropathy) is owing to quantitative and/or qualitative differences in immune suppressants. Besides immunosuppression, other probable risk factors for BKV infection were recognized. Whilst some of them were reproducible in many of these studies, they were denied by others. For instance, ureteric stents, recipient's age, race, deceased-donor type and acute rejection episodes, were inconsistently recognised as significant risk factors for BKV infection. Conclusions: Over immunosuppression remained the reproducible risk factor for BKV infection in all studies, never the less published data on other risks factors varies. This may mirror the patient's geographical area, genetic vulnerability and probably a different BK gene variant with different risk susceptibility, these warrant further investigation. [ABSTRACT FROM AUTHOR]