A recent paper in Transplantation ( multi institutional) looked at this exact question. How safe and well do patients when they get a re transplantation of the kidney after failed prior transplant from BK Nephropathy.
This retrospective study evaluated 31 patients from 6 centers. 26/31 had documented clearance of viremia and 13 underwent transplant nephrectomy before the new transplant. Only 2 patients in the new transplants got BK nephropathy. 7/31 had acute rejection. The patients who had BK viremia and replications had higher 1 year creatinine. One graft was lost due to rejection. But overall, majority did well. Based on this small trial, the authors conclude that re transplantation is safe and effective for patients with prior graft loss due to BK Nephropathy but preferably post BK viral clearance.
Take a look at the full article at:
http://www.ncbi.nlm.nih.gov/pubmed/21836535
Interesting but one flaw is they are assuming BK viral replication post transplant equals bad outcome. The patients who did not clear their viral load prob just had reactivation of BK in the failed allograft. As evidence of this both patients with documented BK nephropathy had viral clearance before re transplant. Tricky.
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Dr Vinay Nair