[Management of BK polyomavirus (BKPyV) in German urological kidney transplant centers]

BK polyomavirus (BKPyV) continues to pose a significant clinical challenge in immunosuppressed patients and, thus, also in kidney transplantation. Here, it primarily leads to BKPyV nephropathy (BKVAN), which is rare but can be associated with transplant failure.

A survey of German urological kidney transplant centers was conducted with the primary study aim of describing the management of BKPyV. Secondary study objectives were to identify implications for further research and implications for the planning of therapy studies.

Between November 2025 and January 2026, the nonvalidated 24-item questionnaire was sent to the relevant transplant centers. Descriptive statistical analysis was performed using SPSS 31.0.

A response rate of 83.3% was achieved. Overall, management of BKPyV is heterogeneous, but is essentially based on plasma virus monitoring in accordance with the second international consensus guideline on BKPyV in kidney transplantation. The most important findings of this survey are the implications for future research: there is a lack of valid predictive markers and causal therapy. In addition, there are indications that these necessary robust studies should be planned on an interdisciplinary and multicenter basis.

Our pilot study, which achieved a high response rate, can raise awareness of this rare topic and points to two important areas of research: the identification of predictive markers or models, and the development of causal therapies, including their testing in appropriate clinical trials.