Extracorporeal Photopheresis for Bronchiolitis Obliterans Syndrome After Lung Transplantation

Hachem, Ramsey R.; Corris, Paul A.

doi:10.1097/tp.0000000000002168

Cited by 52 publications

(34 citation statements)

References 52 publications

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“…However, over the years, the indications for ECP have increased as it promotes anti-inflammatory and tolerogenic responses without causing global immuno-suppression[40]. In solid organ transplantation, ECP has been successfully used to treat acute heart allograft rejection and chronic allograft dysfunction after lung transplantation[41,42]. In addition, ECP was also used as a part of calcineurin inhibitor (CNI) sparing protocols to reduce drug side effects such as nephrotoxicity, and neurological or infectious complications[43].…”

Section: Selective Ta Techniquesmentioning

confidence: 99%

Therapeutic apheresis in kidney transplantation: An updated review

Salvadori¹,

Tsalouchos²

2019

WJT

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Therapeutic apheresis is a cornerstone of therapy for several conditions in transplantation medicine and is available in different technical variants. In the setting of kidney transplantation, immunological barriers such as ABO blood group incompatibility and preformed donor-specific antibodies can complicate the outcome of deceased- or living- donor transplantation. Postoperatively, additional problems such as antibody-mediated rejection and a recurrence of primary focal segmental glomerulosclerosis can limit therapeutic success and decrease graft survival. Therapeutic apheresis techniques find application in these issues by separating and selectively removing exchanging or modifying pathogenic material from the patient by an extracorporeal aphaeresis system. The purpose of this review is to describe the available techniques of therapeutic aphaeresis with their specific advantages and disadvantages and examine the evidence supporting the application of therapeutic aphaeresis as an adjunctive therapeutic option to immunosuppressive agents in protocols before and after kidney transplantation.

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Section: Selective Ta Techniquesmentioning

confidence: 99%

Therapeutic apheresis in kidney transplantation: An updated review

Salvadori¹,

Tsalouchos²

2019

WJT

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“…Over the years, indications for ECP have increased as it promotes anti-inflammatory and tolerogenic responses without causing global immunosuppression [75]. In solid organ transplantation, ECP has been successfully applied to treat acute heart allograft rejection and chronic allograft dysfunction after lung transplantation [76,77]. In addition, ECP has been used as a part of calcineurin inhibitor (CNI) sparing protocols to reduce the drug side effects such as nephrotoxicity and the neurological or infectious complications [78].…”

Section: Extracorporeal Photopheresismentioning

confidence: 99%

Therapeutic Apheresis in Prevention and Treatment of Antibody-Mediated Rejection of Renal Allografts

Salvadori¹,

Tsalouchos²

2019

obm transplant

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Antibody-mediated rejection represents a significant barrier to favorable long-term outcomes after kidney transplantation and remains the most common cause of allograft failure. Therapeutic apheresis techniques are commonly used, in combination with other treatments such as immunosuppressive drugs, in the pre-transplant and post-transplant protocols for the prevention and treatment of antibody-mediated injury. The rationale is to remove the donor-specific antibodies and the other inflammatory mediators, which include cytokines, chemokines, and complement degradation molecules, and it is also related to immunomodulatory effects which determine an increased susceptibility of cell-mediated and humoral immunity to immunosuppressive agents. In the present review article, current knowledge regarding the use of therapeutic apheresis in combination with the known and emerging biological immunosuppressive therapies, for the prevention and management of antibody-mediated rejection, has been discussed.

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“…They consist on increasing immunosuppression, minimize the risk of infection with nebulized antibiotherapy, and early treatment of bronchial colonization, especially Pseudomonas. Other therapeutic measures to consider are treatment of gastroesophageal reflux, pulmonary rehabilitation, thymoglobulin, and extracorporeal photoapheresis [ 68 ]. In selected young patients with progressive evolution, retransplantation can be considered as an exceptional measure.…”

Section: Post-transplant Monitoringmentioning

confidence: 99%

Lung Transplantation in Idiopathic Pulmonary Fibrosis

et al. 2018

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Despite the advances in recent years in the treatment of idiopathic pulmonary fibrosis (IPF), it continues to be a progressive disease with poor prognosis. In selected patients, lung transplantation may be a treatment option, with optimal results in survival and quality of life. Currently, pulmonary fibrosis is the main cause of lung transplantation. However, mortality on the waiting list of these patients is high, since many patients are referred to the transplant units with advanced disease. There is not a parameter that can predict the survival of a specific patient. Different variables are to be considered in order to decide the right time to send them to a transplant unit. It is also very difficult to decide when to include these patients on the waiting list. Every patient diagnosed with IPF, without contraindications for surgery, should be referred early to a transplant unit for assessment. A uni or bilateral transplantation will be decided based on the characteristics of the patient and the experience of each center. The post-transplant survival of recipients with IPF is lower than that observed in other diseases, such as cystic fibrosis or chronic obstructive pulmonary disease as a consequence of their older age and the frequent presence of associated comorbidity. Post-transplant follow-up must be tight in order to assure optimal level of immunosuppressive treatment, detect complications associated with it, and avoid graft rejection. The main cause of long-term mortality is late graft dysfunction as a consequence of chronic rejection. Other complications, such as infections and tumors, must be considered.

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Extracorporeal Photopheresis for Bronchiolitis Obliterans Syndrome After Lung Transplantation

Cited by 52 publications

References 52 publications

Therapeutic apheresis in kidney transplantation: An updated review

Therapeutic apheresis in kidney transplantation: An updated review

Therapeutic Apheresis in Prevention and Treatment of Antibody-Mediated Rejection of Renal Allografts

Lung Transplantation in Idiopathic Pulmonary Fibrosis

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