Seraph 100 Microbind Affinity Blood Filter for Persistent Pediatric BK Virus Nephropathy

Area of Science:

• Nephrology
• Virology
• Transplantation Immunology

Background:

• BK viremia is a significant barrier to kidney transplantation, with limited effective therapies.
• Current management often involves immunosuppression reduction, which can be insufficient.
• The Seraph 100 filter utilizes heparin sulfate proteoglycans to bind pathogens, mimicking natural glycocalyx function.

Observation:

• A 14-year-old patient with a history of cardiac transplant developed BK nephropathy and end-stage kidney disease (ESKD).
• Despite 4 years of medical management and immunosuppression reduction, BK viral replication persisted.
• The Seraph 100 Microbind Affinity Blood Filter was used extracorporeally with continuous renal replacement therapy (CRRT) for 48 hours.

Findings:

• BK viral titers, after an initial slight increase, cleared within two months post-treatment.
• The patient successfully underwent kidney transplantation without BK viremia recurrence.
• No adverse events were noted, apart from transient emesis at CRRT initiation.

Implications:

• This case presents proof of concept for the Seraph 100 filter's efficacy in clearing BK viremia.
• The Seraph 100 may offer a viable therapeutic option for ESKD patients with existing dialysis access.
• Further studies are warranted to explore the Seraph 100 as a treatment for BK viral infections.