BK Polyomavirus Infection and Renourinary Tumorigenesis

John C. Papadimitriou*, P. Randhawa, C. Hanssen Rinaldo, C. B. Drachenberg, B. Alexiev, H. H. Hirsch

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

72 Scopus citations


BK polyomavirus (BKPyV) infection represents a major problem in transplantation, particularly for renal recipients developing polyomavirus-associated nephropathy (PyVAN). The possibility that BKPyV may also be oncogenic is not routinely considered. Twenty high-grade renourinary tumors expressing polyomavirus large T antigen in the entirety of the neoplasm in 19 cases, including the metastases in six, have been reported in transplant recipients with a history of PyVAN or evidence of BKPyV infection. Morphological and phenotypical features consistent with inactivation of the tumor suppressors pRB and p53 were found in the bladder tumors, suggesting a carcinogenesis mechanism involving the BKPyV large tumor oncoprotein/antigen. The pathogenesis of these tumors is unclear, but given the generally long interval between transplantation and tumor development, the risk for neoplasms after BKPyV infections may well be multifactorial. Other elements potentially implicated include exposure to additional exogenous carcinogens, further viral mutations, and cell genomic instability secondary to viral integration, as occurs with the Merkel cell PyV-associated carcinoma. The still scarce but increasingly reported association between longstanding PyVAN and renourinary neoplasms requires a concerted effort from the transplant community to better understand, diagnose, and treat the putative association between the BKPyV and these neoplasms.

Original languageEnglish (US)
Pages (from-to)398-406
Number of pages9
JournalAmerican Journal of Transplantation
Issue number2
StatePublished - Feb 1 2016


  • cancer
  • cancer malignancy neoplasia
  • clinical research practice
  • histopathology
  • infection and infectious agents, viral, infection and infectious agents, viral: BK / JC / polyoma
  • infectious disease
  • kidney transplantation
  • malignancy neoplasia risk factors
  • nephrology pathology

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)


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