Extracorporeal photopheresis in lung transplant:The initial experience in our hospital

INTRODUCTION Extracorporeal photopheresis(ECP)could be a helpful treatment to slow progression of Bronchiolitis Obliterans Syndrome(BOS)as a manifestation of chronic rejection(CR)in lung transplantation(LT). OBJECTIVE To describe our experience with ECP in LT patients with CR not responding to other treatments. PATIENTS&METHODS LT patients with CR,as a progressive fall in respiratory flows despite changes in immunosuppression therapy,corticosteroid bolus and thymoglobulin. ECP is performed according to a protocol:2 sessions/week for the first month,2 sessions/2 weeks for 3 months,followed by 2 sessions/month. FEV1 is measured every 2 sessions. A response is considered positive when the FEV1 has stabilized and/or the FEV1 has decreased less than during the previous three months. RESULTS The study includes 9 patients.4 male(44.4%).Mean age 49.89±17.4 years. 3 patients were affected by cystic fibrosis,2 by usual interstitial pneumonia,2 by emphysema,1α-1-antitrypsin deficit and 1 with lymphangioleiomyomatosis as the underlying disease. Mean time from LT is 2534±1524 days. The mean pre-ECP FEV1 is 1218±354. CONCLUSIONS Photophoresis can be helpful in slowing the progression of CR.