Successful Management of BK Virus Nephropathy Following Kidney Transplant in Nigeria: A Report of Two Cases

BK Polyomavirus Associated Nephropathy (BKVAN) is an important emerging complication of renal transplantation. BK Virus (BKV) is an opportunistic pathogen that actively replicates in those with impaired immunity and its emergence is attributed to the use of more potent immunosuppressive drugs following renal transplant. The virus induces cytopathic changes in renal cells with commonly asymptomatic presentation, but if left untreated, leads to nephropathy and graft loss. Management of this emerging complication in transplant centres in Nigeria has not been reported. We therefore describe the successful treatment of BKVAN in two patients who had progressive impairment of renal function post-transplantation. A reduction in the dose of tacrolimus and withdrawal of Mycophenolate Mofetil (MMF) in the case 1 and replacement of MMF with Sirolimus in addition to a reduced dose of tacrolimus in case 2 improved graft function remarkably without any drug side-effects or further complications.