A week has gone by and it is time to fill you in on both the BK Virus and the CMV or Cytomegalovirus and how both affect transplant patients and their transplanted organ. So, let's begin with the BK Virus...
(Definition from the UC Davis Transplant Center)
BK Virus
Actual damage in the kidney can be detected by a kidney biopsy. Kidney injury develops late in the course of BK virus disease and screening and early treatment is beneficial for long-term transplant survival. Screening for the BK virus in kidney recipients usually occurs via blood or urine tests. [Our] Programs routinely screen for BK virus to allow for early detection and treatment. Reducing the amount of immunusuppressive (anti-rejection) medication can help to decrease the virus. A medication called leflunomide has also been shown to inhibit BK virus in the blood which prevents injury to the transplanted kidney."
What is BK virus?
"BK virus is a virus that most people get in childhood. Symptoms can feel like a common cold. Once you get a BK virus infection, the virus stays in your system for good. But it does not cause a problem for most people. This is called latent, or like being ‘asleep’ in your body. Sometimes, when your immune system is not working well, the virus wakes up. Then it can cause symptoms of infection. BK virus is also called polyomavirus.
What increases the risk for BK virus infection?
- Organ transplant, like a kidney transplant
- Kidney surgery or injury
- Older age
- Health conditions that weaken your immune system (HIV and Diabetes, to name a few)
How does transplantation increase the risk for BK virus problems?
After your transplant, you will take special “anti-rejection” medicines. They cause your white blood cells not to work as well. White blood cells help your body fight infection. When you take these medicines, your body has a higher risk for infection. You can have BK virus in your system and not be aware of it. After your transplant, the virus may become active again. This is from the anti-rejection medicines. It can damage your new kidney and cause your body to reject it.
How will I know if the BK virus is in my system?
Your healthcare provider will check for signs of the virus in your system. They will check both before and after receiving your kidney transplant. Since BK virus can “wake up,” it is important to watch for signs of infection. Symptoms may include:
- Changes in vision, like blurred vision
- Changes in the color of your urine (urine that is brown or red in color)
- Pain when you urinate
- Difficulty urinating
- Needing to urinate more than is normal for you
- A cough, cold, or trouble breathing
- Fever, muscle pain, or weakness
- Seizures
Having any of these symptoms could be a sign of infection. This can affect the success of your kidney transplant. It is important to tell your healthcare provider if you notice any signs of infection.
How will I be monitored for BK virus infection?
After your transplant, your blood and/or urine will be checked on a regular schedule. Your healthcare provider will decide how often to check you for BK virus and other infections. This helps make sure your transplant is not at risk."
Now, let's define CMV, or Cytomegalovirus...
(From Ohio State University's Wexner Medical Center)
Cytomegalovirus (CMV): Risk for the Transplant Patient
"Cytomegalovirus is part of the herpes virus family. It is usually harmless to people with healthy immune systems. After the transplant, you will be on several drugs to prevent rejection of your new organ. These drugs suppress your immune system so you may be at higher risk for CMV infection.
How do I know if I have CMV?
How do I know if I have CMV?
Blood is drawn during your transplant work up to check for CMV in your system. A careful screening also is done to check for this virus in the donor. Even if you have never been exposed to CMV, the person who donated your organ may have been exposed. Knowing if one or both of you have been exposed helps the transplant team take care of you after the transplant.
Most people with strong immune systems do not know that they have been exposed to CMV. CMV may remain dormant in your body for life but can reactivate at any time when your immune system is weak or suppressed.
CMV is spread by close contact with body fluids. Body fluids are urine, saliva, blood, tears, and sexual fluids.
Signs of CMV infection CMV can infect any organ.
Some signs of CMV infection include:
*Fever greater than 101 degrees F (38 degrees C)
*Muscle weakness
*Fatigue
*Headache, confusion, seizure
*Arthritis pain in joints
*Blurry or loss of vision in one eye
*Shortness of breath
*Blood in stool, abdominal discomfort, nausea and vomiting
How is CMV diagnosed?
Sample of blood, urine and sputum may be cultured to see if the CMV virus is active. Other blood tests also may be done. In some cases, a biopsy of the infected organ is done. This means a sample of tissue is removed from the organ for testing.
Prevention and Treatment
If blood tests show that you have CMV before your transplant, antiviral medicines are given. Additional tests may be used to check your condition. Because this virus lays dormant in your body, it is possible that you may become infected at any time during your life after transplant. Even if you show no sign of infection, you may be given antiviral medicines after transplant to reduce your risk of infection. Not every transplant patient develops CMV. However, an infection can be very serious. Antiviral medicines may be given to prevent the spread of infection, but do not cure it.
You need to contact your transplant team right away when you are not feeling well."
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