Extracorporeal Photochemotherapy as Adjuvant Treatment of Heart Transplant Recipients With Recurrent Rejection

Dall’Amico, Roberto; Livi, Ugolino; Milano, A; Montini, Giovanni; Andreetta, Barbara; Murer, Luisa; Zacchello, Graziella; Thiene, Gaetano; Casarotto, D; Zacchello, Franco

doi:10.1097/00007890-199507150-00009

Cited by 57 publications

(29 citation statements)

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“…ECP, which is similar in some ways to PUVA, is currently used for the treatment of cutaneous T-cell lymphoma (CTCL) and has proved beneficial in autoimmune diseases such as pemphigus vulgaris, lupus and scleroderma, and in the treatment of rejection after organ transplantation (CostanzoNordin et al, 1992;Dall'Amico et al, 1995;Edelson et al, 1987;Knobler et al, 1992;Rook et al, 1990Rook et al, , 1992Rose et al, 1992). ECP is performed by treating lymphocytes, removed from the patients by leukapheresis, with 8-MOP and UVA in an extracorporeal system.…”

mentioning

confidence: 99%

Photopheresis in paediatric patients with drug‐resistant chronic graft‐versus‐host disease

Dall’Amico¹,

Rossetti²,

Zulian³

et al. 1997

Br J Haematol

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Summary. Photopheresis (ECP) is a new type of photochemotherapy, used for the treatment of oncological and autoimmune diseases. Lymphocytes are drawn from the patients by leukapheresis, treated with 8-methoxypsoralen (8-MOP) and ultraviolet light A (UVA) in an extracorporeal system and then reinfused. Skin exposure to 8-MOP and UVA (PUVA) has been shown to relieve cutaneous symptoms of graft-versus-host disease (GVHD) in bone marrow transplant (BMT) recipients. ECP, which is similar in some ways to PUVA, has been used in this study to treat four paediatric patients who developed chronic GVHD following BMT and in whom GVHD had failed to respond to conventional immunosuppressive therapy. Following ECP, skin lesions cleared almost completely and pulmonary function tests improved in two of three patients with cutaneous and lung involvement. Serum bilirubin and transaminases gradually normalized, and gGT decreased considerably in the remaining patient who had a severe cholestatic hepatopathy. The Karnofsky performance score increased to 90% in the three patients with positive responses to ECP and remained unchanged (40%) in the patient who did not respond. Immunosuppressive therapy was reduced in three patients and eventually discontinued in two. No significant sideeffects were observed during the treatment. Our results suggest that ECP is a non-aggressive treatment that may benefit patients with chronic GVHD who do not respond to standard immunosuppressive therapy.

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mentioning

confidence: 99%

Photopheresis in paediatric patients with drug‐resistant chronic graft‐versus‐host disease

Dall’Amico¹,

Rossetti²,

Zulian³

et al. 1997

Br J Haematol

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“…In parallel to ECP treatment for GVHD, ECP has been developed for lung and heart transplantation and is characterized by the lack substitute treatment in case of transplant rejection and failure [40,41]. In heart transplantation, the success in prevention or treatment of transplant rejection from ECP described at the end of the 90's is counterbalanced by the progress in managing immunosuppressive drugs.…”

Section: Solid Organ Transplantation: From Rejection Treatment To Immmentioning

confidence: 99%

Extracorporeal Photopheresis: Scientific and Technical Considerations for Improving Clinical Management of Patients

Garban¹,

Makowski

Carras

et al. 2014

J Stem Cell Res Ther

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“…In 1995, a small study of eight patients suggested that when ECP was added to the immunosuppressive regimen, 87.5% of the patients had fewer and less-severe rejection episodes compared with their own historical data pre-ECP [22]. An additional benefit of ECP was the ability to taper immunosuppressive drugs in patients treated with ECP.…”

Section: Studies Of the Response Of Cardiac Allograft Recipients To Ecpmentioning

confidence: 99%

Update on extracorporeal photopheresis in heart and lung transplantation

Marques

Schwartz

2010

J of Clinical Apheresis

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Transplant rejection of solid organs remains a threat to thousands of patients despite modern immunosuppressive regimens. The currently available drugs are associated with severe complications such as hypertension, diabetes mellitus, renal failure, risk of infections, and malignancies among many others and, often enough, still allow episodes of rejection. New and less-toxic immunologic measures are desperately needed to accomplish the desired tolerance to the transplant without the undesirable side effects. Extracorporeal photopheresis (ECP) has been shown to benefit especially patients with cardiac transplants, but also those who received lung allografts. ECP likely modulates the recipient's antigen-specific immune responses and inflammation in transplantation by in vivo generation of apoptotic leukocytes. This review will highlight the need for ECP, how it is thought to act, and the published evidence for its role in cardiac and pulmonary transplantation.

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Extracorporeal Photochemotherapy as Adjuvant Treatment of Heart Transplant Recipients With Recurrent Rejection

Cited by 57 publications

References 0 publications

Photopheresis in paediatric patients with drug‐resistant chronic graft‐versus‐host disease

Photopheresis in paediatric patients with drug‐resistant chronic graft‐versus‐host disease

Extracorporeal Photopheresis: Scientific and Technical Considerations for Improving Clinical Management of Patients

Update on extracorporeal photopheresis in heart and lung transplantation

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