Polyomavirus disease under new immunosuppressive drugs: a cause of renal graft dysfunction and graft loss

Transplantation. 1999 Mar 27;67(6):918-22. doi: 10.1097/00007890-199903270-00022.


Background: Manifest polyomavirus (PV) renal graft infection is a rare complication. We diagnosed 5 cases among 70 kidney recipients undergoing transplants since December 1995; however, there were no cases at our institution before December 1995.

Method: To identify risk factors promoting manifest PV graft infection, we compared those 5 patients with kidney recipients who had signs of PV replication but no manifest graft infection (n=23, control group). PV replication was judged by the presence of intranuclear inclusion cells in the urine.

Results: Before the infection, five of five patients had recurrent rejection episodes. All were switched from cyclosporine A to high dose tacrolimus as rescue therapy. Infection was diagnosed histologically 9+/-2 months posttransplantation; it persisted and led to graft loss in four of five patients. In control patients, graft function was stable, 1 of 23 patients were switched to tacrolimus as rescue therapy, and graft loss occurred in 4 of 23 patients.

Conclusion: Recurrent rejection episodes and high dose immunosuppressive therapy, including tacrolimus, are risk factors for manifest PV kidney graft infection, which has an ominous prognosis.

MeSH terms

  • Graft Rejection*
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Kidney Transplantation / adverse effects*
  • Polyomavirus Infections / complications*
  • Polyomavirus*
  • Risk Factors
  • Tumor Virus Infections / complications*


  • Immunosuppressive Agents