BK polyomavirus infection: more than 50 years and still a threat to kidney transplant recipients

BK polyomavirus (BKPyV) is a ubiquitous human polyomavirus and a major infection after kidney transplantation, primarily due to immunosuppression. BKPyV reactivation can manifest as viruria in 30%–40%, viremia in 10%–20%, and BK polyomavirus-associated nephropathy (BKPyVAN) in 1%–10% of recipients. BKPyVAN is an important cause of kidney graft failure. Although the first case of BKPyV was identified in 1971, progress in its management has been limited. Specifically, there is no safe and effective antiviral agent or vaccine to treat or prevent the infection. Even in the current era, the mainstay approach to BKPyV is a reduction in immunosuppression, which is also limited by safety (risk of de novo donor specific antibody and rejection) and efficacy (graft failure). However, recently BKPyV has been getting more attention in the field, and some new treatment strategies including the utilization of viral-specific T-cell therapy are emerging. Given all these challenges, the primary focus of this article is complications associated with BKPyV, as well as strategies to mitigate negative outcomes

Wildlife assessment of the Chandragiri hills, Kathmandu: Potentiality for ecotourism

Wildlife assessments can provide crucial information regarding species richness, relative abundance and spatial, temporal, and ecological information on wildlife habitat associations. The assessment’s information can in turn be used for developing management policies including for establishing touristic zones. We investigated wildlife occurrences in the Chandragiri Hills, Kathmandu Nepal from 2015-2019 to provide baseline data to inform the potential sites for ecotourism. During the study period, we recorded 30 mammal species, 199 bird species, 34 herpetofauna species and 77 butterfly species. The area harbors three globally and six nationally threatened mammal species, two globally and seven nationally threatened with one endemic bird species, one globally and nationally threatened herpetofauna, and one nationally threatened butterfly species. We also explored four potential hiking routes for observing wildlife and providing scenic views of the Himalayan range and Kathmandu city. Therefore, we expect Chandragiri Hills can become one of the hot spot for tourists to observe both common and threatened wildlife species in Nepal

Analysis of Rejection, Infection and Surgical Outcomes in Type I Versus Type II Diabetic Recipients After Simultaneous Pancreas-Kidney Transplantation

Given the increasing frequency of simultaneous pancreas-kidney transplants performed in recipients with Type II diabetes and CKD, we sought to evaluate possible differences in the rates of allograft rejection, infection, and surgical complications in 298 Type I (T1D) versus 47 Type II (T2D) diabetic recipients of simultaneous pancreas-kidney transplants between 2006-2017. There were no significant differences in patient or graft survival. The risk of biopsy-proven rejection of both grafts was not significantly different between T2D and T1D recipients (HRpancreas = 1.04, p = 0.93; HRkidney = 0.96; p = 0.93). Rejection-free survival in both grafts were also not different between the two diabetes types (ppancreas = 0.57; pkidney = 0.41). T2D had a significantly lower incidence of de novo DSA at 1 year (21% vs. 39%, p = 0.02). There was no difference in T2D vs. T1D recipients regarding readmissions (HR = 0.77, p = 0.25), infections (HR = 0.77, p = 0.18), major surgical complications (HR = 0.89, p = 0.79) and thrombosis (HR = 0.92, p = 0.90). In conclusion, rejection, infections, and surgical complications after simultaneous pancreas-kidney transplant are not statistically significantly different in T2D compared to T1D recipients