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Importance of molecular diagnostic of viral infections in renal transplant recipients

PhD ceremony:Ms L. (Lilli) Rurenga-Gard
When:September 04, 2019
Supervisors:prof. dr. H.G.M. (Bert) Niesters, prof. dr. W.J. (Willem) van Son
Co-supervisors:dr. A. Riezebos-Brilman, dr. J.S.F. (Jan-Stephan) Sanders
Where:Academy building RUG
Faculty:Medical Sciences / UMCG
Importance of molecular diagnostic of viral infections in renal
transplant recipients

Renal transplantation has for patients with end-stage renal disease significant survival and quality of life benefits, compared to dialysis. One of the most important complications after renal transplantation is the rejection of the kidney, also known as rejection. To prevent rejection, patients after renal transplantation are treated with agents that suppress the immune system, the so-called immunosuppressive drugs. These immunosuppressive drugs and their treatment have been improved in recent decades.  Patients, however, still face the downside of these immunosuppressive drugs, one of the major side effects are viral infections, which still lead to more disease and mortality.The presented studies in this thesis focus on the impact of BK Polyomavirus, Cytomegalovirus and Epstein-Barr virus infections after renal transplantation, with the focus of the necessity in diagnostic screening for these viruses to improve patient management and transplantation outcome. Insight was gained into the development of improved diagnostic tests, the effect of immunosuppressive treatment and the frequency of monitoring the amount of virus present. The implementation of the diagnostic tests for the Cytomegalovirus, the Epstein-Barr virus and the BK Polyomavirus certainly help to identify patients at high risk of post-transplant complications. Here the challenge is for the treated doctor to find a good balance between the risk of under-immune suppression and possible rejection and the risks of over-immune suppression and associated infections.