.. Critère-composite-et-morbi-mortalité, 40 II-Analyse des facteurs pronostiques, p.41

H. Hirsch, W. Knowles, M. Dickenmann, J. Passweg, T. Klimkait et al., Prospective Study of Polyomavirus Type BK Replication and Nephropathy in Renal-Transplant Recipients, New England Journal of Medicine, vol.347, issue.7, pp.488-96, 2002.
DOI : 10.1056/NEJMoa020439

D. Brennan, I. Agha, D. Bohl, M. Schnitzler, K. Hardinger et al., Incidence of BK with Tacrolimus Versus Cyclosporine and Impact of Preemptive Immunosuppression Reduction, American Journal of Transplantation, vol.27, issue.3, pp.582-94, 2005.
DOI : 10.1016/S1053-2498(02)01159-2

O. Pappo, A. Demetris, R. Raikow, and P. Randhawa, Human polyoma virus infection of renal allografts: histopathologic diagnosis, clinical significance, and literature review, Mod Pathol, vol.9, issue.2, pp.105-114, 1996.

V. Nickeleit, H. Hirsch, M. Zeiler, F. Gudat, O. Prince et al., BK-virus nephropathy in renal transplants--tubular necrosis, MHC-class II expression and rejection in a puzzling game, Nephrology Dialysis Transplantation, vol.15, issue.3, pp.324-356, 2000.
DOI : 10.1093/ndt/15.3.324

H. Hirsch, D. Brennan, C. Drachenberg, F. Ginevri, J. Gordon et al., Polyomavirus-Associated Nephropathy in Renal Transplantation: Interdisciplinary Analyses and Recommendations, Transplantation, vol.79, issue.10, pp.1277-86, 2005.
DOI : 10.1097/01.TP.0000156165.83160.09

P. Randhawa and D. Brennan, BK Virus Infection in Transplant Recipients: An Overview and Update, American Journal of Transplantation, vol.40, issue.9, pp.2000-2005, 2006.
DOI : 10.1111/j.1600-6143.2005.01137.x

E. Ramos, C. Drachenberg, M. Portocarrero, R. Wali, D. Klassen et al., BK virus nephropathy diagnosis and treatment: experience at the University of Maryland Renal Transplant Program, Clin Transpl, pp.143-53, 2002.

H. Hirsch and P. Randhawa, BK Virus in Solid Organ Transplant Recipients, American Journal of Transplantation, vol.87, issue.supl 2, pp.136-182, 2009.
DOI : 10.1111/j.1600-6143.2009.02904.x

S. Gardner, A. Field, D. Coleman, and B. Hulme, NEW HUMAN PAPOVAVIRUS (B.K.) ISOLATED FROM URINE AFTER RENAL TRANSPLANTATION, The Lancet, vol.297, issue.7712, pp.1253-1260, 1971.
DOI : 10.1016/S0140-6736(71)91776-4

H. Hirsch, J. Steiger, and B. Polyomavirus, Polyomavirus BK, The Lancet Infectious Diseases, vol.3, issue.10, pp.611-634, 2003.
DOI : 10.1016/S1473-3099(03)00770-9

C. Bechert, V. Schnadig, D. Payne, and J. Dong, Monitoring of BK Viral Load in Renal Allograft Recipients by Real-Time PCR Assays, American Journal of Clinical Pathology, vol.133, issue.2, pp.242-50, 2010.

D. Friedman and A. Flanders, MR Imaging of BK virus encephalitis, AJNR Am J Neuroradiol, vol.27, issue.5, pp.1016-1024, 2006.

J. Hix, W. Braun, and C. Isada, Delirium in a Renal Transplant Recipient Associated with BK Virus in the Cerebrospinal Fluid, Transplantation, vol.78, issue.9, pp.1407-1415, 2004.
DOI : 10.1097/01.TP.0000137106.09925.8B

H. Hirsch, BK Virus: Opportunity Makes a Pathogen, Clinical Infectious Diseases, vol.41, issue.3, pp.354-60, 2005.
DOI : 10.1086/431488

URL : http://cid.oxfordjournals.org/cgi/content/short/41/3/354

L. Emerson, H. Carney, L. Layfield, and J. Sherbotie, hybridization study, Pediatric Transplantation, vol.7, issue.5, pp.600-605, 2008.
DOI : 10.1111/j.1399-3046.2007.00855.x

D. Geetha, B. Tong, L. Racusen, J. Markowitz, and W. Westra, Bladder carcinoma in a transplant recipient: evidence to implicate the BK human polyomavirus as a causal transforming agent, Transplantation, vol.73, issue.12, pp.1933-1939, 2002.
DOI : 10.1097/00007890-200206270-00015

A. Sundsfjord, A. Osei, H. Rosenqvist, M. Van-ghelue, Y. Silsand et al., BK and JC Viruses in Patients with Systemic Lupus Erythematosus: Prevalent and Persistent BK Viruria, Sequence Stability of the Viral Regulatory Regions, and Nondetectable Viremia, The Journal of Infectious Diseases, vol.180, issue.1, pp.1-9, 1999.
DOI : 10.1086/314830

P. Randhawa, J. Uhrmacher, W. Pasculle, A. Vats, R. Shapiro et al., A comparative study of BK and JC virus infections in organ transplant recipients, Journal of Medical Virology, vol.74, issue.2, pp.238-281, 2005.
DOI : 10.1002/jmv.20442

A. Moreau, Infections virales In: Noël LH Atlas de pathologie rénale, Paris: Flammarion Medecine-Sciences, pp.875-885, 2008.

D. Sawinski and S. Goral, BK virus infection: an update on diagnosis and treatment, Nephrology Dialysis Transplantation, vol.30, issue.2, pp.209-226, 2015.
DOI : 10.1093/ndt/gfu023

D. Bohl and D. Brennan, BK Virus Nephropathy and Kidney Transplantation, Clinical Journal of the American Society of Nephrology, vol.2, issue.Supplement 1, pp.36-46, 2007.
DOI : 10.2215/CJN.00920207

H. Hirsch, R. Bowden, P. Ljungman, and D. Snydman, Polyoma and Papilloma Virus Infections after Hematopoietic Cell or Solid Organ Transplantation, pp.468-978, 2010.

P. Comoli, H. Hirsch, and F. Ginevri, Cellular immune responses to BK virus, Current Opinion in Organ Transplantation, vol.13, issue.6, pp.569-74, 2008.
DOI : 10.1097/MOT.0b013e3283186b93

E. Ramos, C. Drachenberg, J. Papadimitriou, O. Hamze, J. Fink et al., Clinical Course of Polyoma Virus Nephropathy in 67 Renal Transplant Patients, Journal of the American Society of Nephrology, vol.13, issue.8, pp.2145-51, 2002.
DOI : 10.1097/01.ASN.0000023435.07320.81

J. Schold, S. Rehman, L. Kayle, J. Magliocca, T. Srinivas et al., Treatment for BK virus: incidence, risk factors and outcomes for kidney transplant recipients in the United States, Transplant International, vol.84, issue.Suppl. 1, pp.626-660, 2009.
DOI : 10.1111/j.1432-2277.2009.00842.x

Y. Awadalla, P. Randhawa, K. Ruppert, A. Zeevi, and R. Duquesnoy, HLA Mismatching Increases the Risk of BK Virus Nephropathy in Renal Transplant Recipients, American Journal of Transplantation, vol.266, issue.10, pp.1691-1697, 2004.
DOI : 10.1097/00007890-200204270-00030

A. Sharif, N. Alachkar, S. Bagnasco, D. Geetha, G. Gupta et al., Incidence and Outcomes of BK Virus Allograft Nephropathy among ABO- and HLA-Incompatible Kidney Transplant Recipients, Clinical Journal of the American Society of Nephrology, vol.7, issue.8, pp.1320-1327, 2012.
DOI : 10.2215/CJN.00770112

D. Bohl, G. Storch, C. Ryschkewitsch, M. Gaudreault-keener, M. Schnitzler et al., Donor Origin of BK Virus in Renal Transplantation and Role of HLA C7 in Susceptibility to Sustained BK Viremia, American Journal of Transplantation, vol.9, issue.9, pp.2213-2234, 2005.
DOI : 10.1016/S0041-1345(03)00818-2

H. Hirsch and P. Randhawa, BK Polyomavirus in Solid Organ Transplantation, American Journal of Transplantation, vol.9, issue.Suppl 4, pp.179-88, 2013.
DOI : 10.1111/ajt.12110

H. Hirsch, F. Vincenti, S. Friman, M. Tuncer, F. Citterio et al., Kidney Transplant Patients Receiving Tacrolimus or Cyclosporine: A Prospective, Randomized, Multicenter Study, American Journal of Transplantation, vol.13, issue.5 Pt 2, pp.136-181, 2013.
DOI : 10.1111/j.1600-6143.2012.04320.x

T. Menter, M. Mayr, S. Schaub, M. Mihatsch, H. Hirsch et al., Pathology of Resolving Polyomavirus-Associated Nephropathy, American Journal of Transplantation, vol.30, issue.6, pp.1474-83, 2013.
DOI : 10.1111/ajt.12218

C. Drachenberg, J. Papadimitriou, H. Hirsch, R. Wali, C. Crowder et al., Histological Patterns of Polyomavirus Nephropathy: Correlation with Graft Outcome and Viral Load, American Journal of Transplantation, vol.308, issue.6, pp.2082-92, 2004.
DOI : 10.1086/383034

A. Fogo, Polyoma Virus Infection, American Journal of Kidney Diseases, vol.37, issue.1, pp.1-2, 2001.
DOI : 10.1053/S0272-6386(13)90036-6

V. Nickeleit and H. Singh, Polyomaviruses and disease, Current Opinion in Organ Transplantation, vol.20, issue.3, pp.348-58, 2015.
DOI : 10.1097/MOT.0000000000000192

S. Schaub, H. Hirsch, M. Dickenmann, J. Steiger, M. Mihatsch et al., Reducing Immunosuppression Preserves Allograft Function in Presumptive and Definitive Polyomavirus-Associated Nephropathy, American Journal of Transplantation, vol.24, issue.Suppl 4, pp.2615-2638, 2010.
DOI : 10.1111/j.1600-6143.2010.03310.x

F. Ginevri, A. Azzi, H. Hirsch, S. Basso, I. Fontana et al., Prospective Monitoring of Polyomavirus BK Replication and Impact of Pre-Emptive Intervention in Pediatric Kidney Recipients, American Journal of Transplantation, vol.7, issue.12, pp.2727-2762, 2007.
DOI : 10.1111/j.1600-6143.2005.01096.x

H. Wadei, A. Rule, M. Lewin, A. Mahale, H. Khamash et al., Kidney Transplant Function and Histological Clearance of Virus Following Diagnosis of Polyomavirus-Associated Nephropathy (PVAN), American Journal of Transplantation, vol.5, issue.Suppl 4, pp.1025-1057, 2006.
DOI : 10.1111/j.1600-6143.2006.01296.x

A. Vats, R. Shapiro, S. Randhawa, P. Scantlebury, V. Tuzuner et al., Quantitative viral load monitoring and cidofovir therapy for the management of BK virus-associated nephropathy in children and adults1, Transplantation, vol.75, issue.1, pp.105-117, 2003.
DOI : 10.1097/00007890-200301150-00020

D. Kuypers, A. Vandooren, E. Lerut, P. Evenepoel, K. Claes et al., Adjuvant Low-Dose Cidofovir Therapy for BK Polyomavirus Interstitial Nephritis in Renal Transplant Recipients, American Journal of Transplantation, vol.10, issue.4, pp.1997-2004, 2005.
DOI : 10.1016/j.virol.2004.03.027

S. Wu, H. Chang, and J. Lian, The effect of low-dose cidofovir on the long-term outcome of polyomavirus-associated nephropathy in renal transplant recipients, Nephrology Dialysis Transplantation, vol.24, issue.3, pp.1034-1042, 2009.
DOI : 10.1093/ndt/gfn675

M. Josephson, D. Gillen, B. Javaid, P. Kadambi, S. Meehan et al., Treatment of Renal Allograft Polyoma BK Virus Infection with Leflunomide, Transplantation, vol.81, issue.5, pp.704-714, 2006.
DOI : 10.1097/01.tp.0000181149.76113.50

A. Sener, A. House, A. Jevnikar, N. Boudville, V. Mcalister et al., Intravenous Immunoglobulin as a Treatment for BK Virus Associated Nephropathy: One-Year Follow-Up of Renal Allograft Recipients, Transplantation, vol.81, issue.1, pp.117-137, 2006.
DOI : 10.1097/01.tp.0000181096.14257.c2

S. Gabardi, S. Waikar, S. Martin, K. Roberts, J. Chen et al., Evaluation of Fluoroquinolones for the Prevention of BK Viremia after Renal Transplantation, Clinical Journal of the American Society of Nephrology, vol.5, issue.7, pp.1298-304, 2010.
DOI : 10.2215/CJN.08261109

G. Knoll, A. Humar, D. Fergusson, O. Johnston, A. House et al., Levofloxacin for BK Virus Prophylaxis Following Kidney Transplantation, JAMA, vol.312, issue.20, pp.2106-2120, 2014.
DOI : 10.1001/jama.2014.14721

B. Vasudev, S. Hariharan, S. Hussain, Y. Zhu, B. Bresnahan et al., BK virus nephritis: Risk factors, timing, and outcome in renal transplant recipients, Kidney International, vol.68, issue.4, pp.1834-1843, 2005.
DOI : 10.1111/j.1523-1755.2005.00602.x

B. Celik, R. Shapiro, A. Vats, and P. Randhawa, Polyomavirus Allograft Nephropathy: Sequential Assessment of Histologic Viral Load, Tubulitis, and Graft Function Following Changes in Immunosuppression, American Journal of Transplantation, vol.10, issue.11, pp.1378-82, 2003.
DOI : 10.1086/320711

K. Hardinger, M. Koch, D. Bohl, G. Storch, and D. Brennan, BK-Virus and the Impact of Pre-Emptive Immunosuppression Reduction: 5-Year Results, American Journal of Transplantation, vol.88, issue.2, pp.407-422, 2010.
DOI : 10.1111/j.1600-6143.2009.02952.x

P. Randhawa, Incorporation of Pathology and Laboratory Findings Into Management Algorithms for Polyomavirus Nephropathy, American Journal of Transplantation, vol.94, issue.6, pp.1379-81, 2013.
DOI : 10.1111/ajt.12226

K. Masutani, R. Shapiro, A. Basu, H. Tan, T. Ninomiya et al., Putative Episodes of T-Cell???Mediated Rejection in Patients With Sustained BK Viruria but No Viremia, Transplantation Journal, vol.94, issue.1, pp.43-52, 2012.
DOI : 10.1097/TP.0b013e318253e7a4

K. Masutani, Current problems in screening, diagnosis and treatment of polyomavirus BK nephropathy, Nephrology, vol.26, issue.Suppl 24, pp.11-17, 2014.
DOI : 10.1111/nep.12254

C. Borni-duval, S. Caillard, J. Olagne, P. Perrin, L. Braun-parvez et al., Risk Factors for BK Virus Infection in the Era of Therapeutic Drug Monitoring, Transplantation Journal, vol.95, issue.12, pp.1498-505, 2013.
DOI : 10.1097/TP.0b013e3182921995

S. Hassan, C. Mittal, S. Amer, F. Khalid, A. Patel et al., /mL underestimates the diagnosis of BKV-associated nephropathy: a single transplant center experience, Transplant Infectious Disease, vol.43, issue.4, pp.55-60, 2014.
DOI : 10.1111/tid.12164

D. Sawinski, K. Forde, J. Trofe-clark, P. Patel, B. Olivera et al., Persistent BK Viremia Does Not Increase Intermediate-Term Graft Loss but Is Associated with De Novo Donor-Specific Antibodies, Journal of the American Society of Nephrology, vol.26, issue.4, pp.966-975, 2015.
DOI : 10.1681/ASN.2014010119

L. Agence-de and . Biomédecine, Rapport médical et scientifique du prélèvement et de la greffe en France, bilan en, 2011.

H. Ekberg, H. Tedesco-silva, A. Demirbas, S. Vitko, B. Nashan et al., Reduced Exposure to Calcineurin Inhibitors in Renal Transplantation, New England Journal of Medicine, vol.357, issue.25, pp.2562-75, 2007.
DOI : 10.1056/NEJMoa067411

P. Sood, S. Senanayake, K. Sujeet, R. Medipalli, Y. Zhu et al., Management and Outcome of BK Viremia in Renal Transplant Recipients, Transplantation Journal, vol.94, issue.8, pp.814-835, 2012.
DOI : 10.1097/TP.0b013e31826690c6

L. Gaber, M. Egidi, R. Stratta, A. Lo, L. Moore et al., Clinical Utility of Histological Features of Polyomavirus Allograft Nephropathy, Transplantation, vol.82, issue.2, pp.196-204, 2006.
DOI : 10.1097/01.tp.0000226176.87700.a4

A. Schwarz, S. Linnenweber-held, A. Heim, V. Brocker, D. Rieck et al., Factors Influencing Viral Clearing and Renal Function During Polyomavirus BK???Associated Nephropathy After Renal Transplantation, Transplantation Journal, vol.94, issue.4, pp.396-402, 2012.
DOI : 10.1097/TP.0b013e31825a505d

H. Singh, H. Reisner, V. Derebail, T. Kozlowski, and V. Nickeleit, Polyomavirus Nephropathy, Transplantation, vol.99, issue.3, pp.609-624, 2015.
DOI : 10.1097/TP.0000000000000367

URL : http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4347732

C. Buehrig, D. Lager, M. Stegall, M. Kreps, W. Kremers et al., Influence of surveillance renal allograft biopsy on diagnosis and prognosis of polyomavirus-associated nephropathy, Kidney International, vol.64, issue.2, pp.665-73, 2003.
DOI : 10.1046/j.1523-1755.2003.00103.x

L. Kayler, I. Batal, R. Mohanka, C. Morgan, A. Basu et al., Antirejection Treatment in Kidney Transplant Patients with BK Viruria, Transplantation, vol.86, issue.6, pp.797-803, 2008.
DOI : 10.1097/TP.0b013e3181837802

P. Comoli, M. Cioni, S. Basso, C. Gagliardone, L. Potenza et al., Immunity to Polyomavirus BK Infection: Immune Monitoring to Regulate the Balance between Risk of BKV Nephropathy and Induction of Alloimmunity, Clinical and Developmental Immunology, vol.345, issue.8941, p.256923, 2013.
DOI : 10.1016/j.virusres.2011.07.017

C. Wiebe, I. Gibson, T. Blydt-hansen, M. Karpinski, J. Ho et al., Evolution and Clinical Pathologic Correlations of De Novo Donor-Specific HLA Antibody Post Kidney Transplant, American Journal of Transplantation, vol.11, issue.5, pp.1157-67, 2012.
DOI : 10.1111/j.1600-6143.2012.04013.x

J. Kahwaji, De Novo Donor Specific Antibody (DSA) After Treatment of BK Infection With Intravenous Immunoglobulin (IVIG) American Transplant Congress, 2015.

T. Schachtner, K. Muller, M. Stein, C. Diezemann, A. Sefrin et al., BK Virus-Specific Immunity Kinetics: A Predictor of Recovery From Polyomavirus BK-Associated Nephropathy, American Journal of Transplantation, vol.5, issue.Suppl 4, pp.2443-52, 2011.
DOI : 10.1111/j.1600-6143.2011.03693.x

. Méthode, Notre étude est descriptive de la population rouennaise greffée rénale ayant présenté une virémie BK >10^3 copies/mL entre Est associée une analyse de survie, avec mise en évidence de facteurs pronostiques d'évolution défavorable du greffon, définie par une majoration de la créatininémie, 2008.

. Au-terme-du-suivi, évolution du greffon est défavorable dans 40,4% des cas, avec un délai moyen de 40,4 mois. Les survies du greffon et patient sont respectivement à 87, pp.7-895

. La-virémie-est, Le traitement est secondairement majoré dans 43,9% des cas Après clairance virale, le taux de rejets est à 19,3%, 8/11 rejets ont une composante humorale. Un donneur plus âgé (HR:1,1; p=0,009) et la survenue d'un rejet après clairance virale (HR:3,5; p=0,008) sont, en analyse multivariée