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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 virus–associated nephropathy (BKVN) is well recognized in kidney allografts; however, it may also occur in native kidneys of patients receiving immunosuppression after other solid organ transplants. Reports in lung transplant recipients remain limited, and optimal management strategies have not been established.
A 43-year-old man with a history of acute lymphoblastic leukemia (ALL) had previously undergone allogeneic bone marrow transplantation from his sister. He remained in remission but developed pulmonary graft-versus-host disease, for which he underwent bilateral deceased-donor lung transplantation at the age of 39. Maintenance immunosuppression consisted of prednisolone, tacrolimus, and mycophenolate mofetil. At the time of lung transplantation, his renal function was normal (serum creatinine 0.89 mg/dL) with no prior urinary abnormalities.
Approximately four years after lung transplantation, he showed a gradual increase in serum creatinine, reaching 1.61 mg/dL. Urinary cytology revealed decoy cells, and plasma BK viral load was 2.2 × 10² copies/mL. Renal biopsy demonstrated enlarged tubular epithelial nuclei with finely granular chromatin (Figure 1), and immunohistochemistry for SV40 large T antigen was positive in tubular epithelial cells, confirming the diagnosis of BK virus nephropathy. To preserve both renal function and lung graft integrity, immunosuppressive drug levels were strictly controlled, and intravenous immunoglobulin (IVIG) therapy (5 g daily for 3 consecutive days) was administered.
Three months after IVIG treatment, a repeat renal biopsy demonstrated histological improvement (Figure 2), and no tubular epithelial cells were positive for SV40 large T antigen. Serum creatinine decreased to 1.39 mg/dL, urinary decoy cells disappeared, and plasma BK viral load became undetectable.
The first-line treatment for BKVN in kidney allografts typically involves reduction of immunosuppression. However, in lung transplant recipients, excessive immunosuppression reduction carries a high risk of fatal allograft rejection. This case demonstrates that IVIG therapy can be a valuable therapeutic option for BK virus nephropathy following lung transplantation when balancing the competing risks of infection and rejection is critical.
