Infections
One of the consequences of effective immunosupprisive therapy is an impared ability to ward off infections (viral, fungal and bacterial). Two of the more frequent infections are:
Polyoma virus (BKV) nephropathy: This common virus causes overt disease in those with a suppressed immune system, and can lead to graft dysfunction. Diagnosis can be made by studying the urinary cytology or by the sensitive PCR assay in which viral DNA is quantified. Present therapy consists of the cautious reduction in the dose of immunosuppressive medication. A number of additional approaches are being studied.
Cytomegalovirus (CMV) infection: CMV, another frequent infection that plays havoc in the transplant population, can occur from reactivation of host infection or from its acquisition in the renal graft. Active CMV infections can involve multiple organs and can be life-threatening. It is so frequent that most programs give prophylactic ganciclovir during the first three months post transplant.