HI @hello1234

So you think the slight elevation of creatinine is due to the lower immune suppressive dosage, and not the AV fistula complication that is present in your transplanted kidney? What can they do to resolve BK virus that is present in your urine? I asked about BK at 1 year checkup and the transplant neph says BK , like CMV, occurs usually during the 1st year of transplant. He says BK/CMV can happen later but very very seldom so he told us not to worry too much about it. But I'll definitely not ignore it and be vigilant.
May I ask how many kidney biopsy protocols have you had post transplant? My hubby's has had 2 (at 4 month and 1 year checkup) and Mayo Az's annual checkup includes kidney biopsy up to the 2 year checkup, however, some of the patients I know only did 1 or 2 max because of COVID when they limited in-person visitation. At 3 year it will just be blood draw labs which can be done locally. After that they do not require any more checkup, unless you experience complications.
Mayo Az recommends the biopsy for all of their transplant patients up to 2 year, because it will help detect early rejections. The transplant neph says it is more reliable than the Prospera test which detects current rejecton. We will discuss with our local neph to get his recommedation(he will probably recommend it because low risk of injury). It's such a difficult decision whether to do the biopsy because it does cary risks of injury and the Prospera lab will not show EARLY rejections which is the reason transplant neph prefers biopsy! There are definitely pros and cons, like everything else in life I'm afraid! I have always understood that risks are real though small in kidney biopsy, but the impact is greater when you actually know someone who is going thru it. Thank you for your advice and bringing this issue to our attention. Please keep us posted on how your treatment goes!