Vol. 6, Issue 1, Part A (2024)

Background: End-stage renal disease (ESRD) patients can survive kidney transplantation, however complications such BK virus-associated nephropathy make graft survival difficult. BKVAN causes kidney transplant allograft dysfunction and failure. This study will examine BKVAN histological alterations, including tubular and interstitial involvement, vascular changes, and immunohistochemistry. 
Method: This research examined 35 BKVAN-diagnosed kidney transplant patients' biopsy findings. Histological findings included tubular epithelial cell infection, interstitial inflammation, fibrosis, vascular involvement, and SV40 T-antigen immunohistochemistry staining. The Banff and Polyomavirus Nephropathy (PVN) classifications were used to assess nephropathy severity. All patients showed significant tubular epithelial BK virus infection with swollen nuclei and viral inclusions. 
Results: The worst cases included up to 65% of the cortical region and showed tubulointerstitial inflammation, interstitial fibrosis, and tubular atrophy (IFTA). Thirty individuals had intimal thickening and a few had arterial hyalinosis. A positive SV40 T-antigen staining indicated BK virus replication in all patients. The majority of patients had PVN stage 2 or 3, suggesting moderate to severe nephropathy. 
Conclusion: Serious histological alterations are linked with progressive BK virus-related nephropathy, which causes post-transplant graft dysfunction. Tubular epithelial infection, interstitial fibrosis, and vascular damage in advanced instances were hallmarks. Early identification and treatment improve transplant survival and patient outcomes.