Evidence map›Paper›PMID 41208378›Full record

ArticleClinical transplantation and research2026

Intravenous immunoglobulin and mammalian target of rapamycin inhibitors for treatment of BK virus infections in kidney transplantation: a systematic review.

Khi Yung Fong, Terence Kee, Sobhana Thangaraju, Quan Yao Ho, Ian Tatt Liew, Carolyn Tien, Edwin Jonathan Aslim, Lay Guat Ng, Ee Jean Lim, Valerie Huei Li Gan

Abstract read
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Article in Clinical transplantation and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Khi Yung FongDepartment of Urology, Singapore General Hospital, Singapore.ORCID https://orcid.org/0000-0001-8194-0800
Terence KeeDepartment of Renal Medicine, Singapore General Hospital, Singapore.ORCID https://orcid.org/0000-0001-5250-855X
Sobhana ThangarajuDepartment of Renal Medicine, Singapore General Hospital, Singapore.ORCID https://orcid.org/0000-0002-0758-1560
Quan Yao HoDepartment of Renal Medicine, Singapore General Hospital, Singapore.ORCID https://orcid.org/0000-0002-0884-7076
Ian Tatt LiewDepartment of Renal Medicine, Singapore General Hospital, Singapore.ORCID https://orcid.org/0000-0003-3777-706X
Carolyn TienDepartment of Renal Medicine, Singapore General Hospital, Singapore.ORCID https://orcid.org/0000-0002-6554-2703
Edwin Jonathan AslimDepartment of Urology, Singapore General Hospital, Singapore.ORCID https://orcid.org/0000-0003-1512-3356
Lay Guat NgDepartment of Urology, Singapore General Hospital, Singapore.ORCID https://orcid.org/0000-0002-3073-5396
Ee Jean LimDepartment of Urology, Singapore General Hospital, Singapore.ORCID https://orcid.org/0000-0002-5242-0651
Valerie Huei Li GanDepartment of Urology, Singapore General Hospital, Singapore.ORCID https://orcid.org/0000-0002-6258-3286

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Reduction of immunosuppression (ROI) remains the mainstay of treatment for BK virus infection (BKVI) in kidney transplantation (KT). This review explored the role of intravenous immunoglobulin (IVIG) and mammalian target of rapamycin inhibitor (mTORi) regimens as alternative therapies for KT recipients with BKVI, focusing on viral clearance and graft-related outcomes. Methods: An electronic search was conducted for articles examining IVIG or mTORi use in treating BKVI among adult and/or pediatric KT recipients. Meta-analyses of proportions were performed for relevant outcomes. Results: Twenty-seven studies (13 evaluating IVIG and 14 evaluating mTORi) were included; all but three enrolled only adult participants. In IVIG studies, the pooled viral clearance rate was 76.4% (95% confidence interval [CI], 64.2%-85.5%), with numerically higher clearance for IVIG after ROI compared to IVIG with ROI (87.0% vs. 66.1%). Overall graft survival was 84.7% (95% CI, 70.7%-92.7%), with numerically higher survival in IVIG after ROI than in IVIG with ROI (93.6% vs. 78.4%). Pooled histological clearance and graft rejection rates were 82.8% and 14.5%, respectively. In mTORi studies, the pooled viral clearance rate was 68.0% (95% CI, 58.0%-76.7%) and overall graft survival was 89.1% (95% CI, 82.7%-93.4%), with no significant difference between patients with and without prior ROI. Histological clearance and graft rejection rates were 59.8% and 8.6%, respectively. Conclusions: IVIG and mTORi regimens appear to be feasible alternatives to ROI in KT recipients with BKVI, achieving viral clearance while maintaining graft survival. Future randomized controlled trials are needed to further define their role and strengthen current evidence with higher-quality data.

Indexed as

BK virusImmunosuppressionIntravenous immunoglobulinKidney transplantationmTOR inhibitors

Identifiers

PMID41208378
PMCPMC13019109

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.