Post Transplant Infection

[alperk]

My wife received kidney from my daughter on 7/9 and both are feeling fine. However on 8/9 my wife had 100 F temp, feeling unwell and was rushed to Tampa General transplant facility. Released after 6 days and feeling very good again. Tacrolimus anti rejection drug reduced from 6 to 3 per day. 8/22 blood test showed BKV at 1.881 whereas it was negative on 8/1 blood test. Got this from Internet research:

"BKV DNA, Quant PCR, Plasma 76, BK Virus DNA Qaunt PCR, SERUM/PLASMA 1.881 A BK Virus DNA Quant PCR value of 1.881 log IU/mL (which is approximately 76 IU/mL) is relatively low. Typically, higher values, especially those exceeding 4 log IU/mL (10,000 IU/mL), are more concerning and may indicate active infection or reactivation, particularly in immunocompromised individuals such as kidney transplant recipients12.

Could BKV at 1.881 be left over from 8/9 infection ? And where did that come from anyway after 8/1 test was negative?

How concerning is all of this?

[wonderingjen]

Alperk - I don't know anything about BKV but I hope this was just a blip and your wife continues to feel good for a very long time to come.

[modernmusic in reply to wonderingjen]

I got through my first year post kidney transplant before I tested positive for BK virus. My transplant coordinator immediately told me to stop taking one of my two anti-rejection meds (CellCept). it took another month for two before I started testing negative for BK again. Eventually added CellCept back to the mix.

[alperk in reply to modernmusic]

Thanks so much for your response. It's comforting to know that this can be managed.

[alperk in reply to wonderingjen]

Thank you🙏

[Merlin_Way]

AI guy, you need to talk to a nephrologist or a transplant specialist. BK virus is of course a serious problem for second-hand kidneys, but I wouldn't worry at this point. Transplants at major hospitals have 'nurselines' you can call at all hours to report sudden changes like fevers, before calling 911. On Monday, I'd schedule for any test or consult that's recommended by her doctor.

[alperk in reply to Merlin_Way]

Thanks. Her transplant team is on it but I, of course, continue to seek any other advice to ease my worry. The reply from modernmusic was therefore quite comforting.

[Merlin_Way in reply to alperk]

I hope this helps. From a thread five years ago:

"As I understand it, BK virus is common; we get it as children; it looks like a cold and our immune system kicks it aside. However, the virus lingers latent in our body, and the immune system kicks it aside again if it tries a comeback. However, our post-transplant immune systems are not at full strength, and the BK can come back. So, the plan is to let the immune system rev up some by stopping the CellCept, so it can kick the BK aside again, and the Prednisone helps prevent rejection until you get back on the CellCept when the BK is gone.

I started the process two weeks ago, and am going tomorrow for the first set of tests to see if the BK is going down. Others here on group have said it takes about 2 months to knock it out.."

[alperk in reply to Merlin_Way]

Thanks and good luck

[ShyeLoverDoctor]

BK is a virus that is dormant in many people’s bodies. It only becomes a problem when you suppress the immune system.

The BK virus can suddenly activate in any person who has a kidney.

BK is generally not fatal for transplant patients but will make you lose your transplant.

Usually when BK reaches very high levels, they will take you off one- not all - of your immunosuppressant drugs so your body can fight it off. They will keep tacrolimus or cyclosporine but remove myfortic or cellcept.

Did your hospital not give you brochures on BK, CMV when you left the transplant center for the first time? Mine did. I had a whole notebook full of it. Please look through all of the educational literature they gave you. It will answer some of your questions.

Anything that affects your transplant is always serious! Especially within the first year where the most rejection happens.

I strongly suggest to read the page on “When to call the doctor”. Again that should help you easily recognize when you need to go to ER or at least call and have them decide. That has to be in the educational information upon discharge, I guarantee it.