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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
BK polyomavirus–associated nephropathy (BKPyVAN) is a known cause of renal allograft dysfunction. Management typically centers on reducing immunosuppression in response to elevated BK viremia. However, cases of progressive renal dysfunction despite improving viral loads raise critical questions regarding the need for histologic evaluation.
We present a case of biopsy-confirmed BKPyVAN in a kidney transplant recipient, in whom renal function worsened despite declining plasma BK viral load. Data collected include serum creatinine, tacrolimus trough levels, BK PCR (copies/mL), immunosuppressive regimen adjustments, IVIG administration, and kidney biopsy performed on September 24, 2024.
The patient initially maintained stable graft function until early August 2024, when BK viremia peaked at nearly 20 million copies/mL. Immunosuppression was gradually reduced (MMF halved then discontinued; tacrolimus dose tapered), and IVIG was administered. By mid-September, BK PCR declined to 1.1 million and reached 1.35 million by September 25. Paradoxically, creatinine rose from 128 µmol/L to 255 µmol/L. A biopsy revealed Banff Class III BKPyVAN with marked interstitial inflammation and SV40 positivity. Immunosuppression was further reduced. By early 2025, BK viremia dropped below 10,000 copies/mL and creatinine stabilized around 170 µmol/L, though full recovery was not achieved.
This case underscores the importance of biopsy in transplant recipients with discordant clinical and virologic trends. Despite effective viral suppression, histologic injury from BKPyVAN may persist or progress. IVIG appeared helpful in viral control, but biopsy enabled a more nuanced understanding of graft injury. Early histopathologic assessment is vital when rising creatinine cannot be solely explained by viral burden, ensuring timely and appropriate adjustments in therapy to preserve graft function.
