title: Photochemotherapy in human heart transplant recipients at high risk for fatal rejection.
abstract: Heart transplant recipients in whom high levels of lymphocytotoxic antibodies directed towards a spectrum of histocompatibility antigens develop frequently represent difficult management problems. Recipients of multiple transplants and multiparous females generally form higher levels of panel reactive antibodies, which have been associated with fatal rejection episodes and accelerated graft atherosclerosis. In this study, two multiple transplant patients with preexistent high levels of panel reactive antibodies and two multiparous women who were considered at risk of sensitization were treated with a new form of immunotherapy termed photochemotherapy in addition to conventional immunosuppression. High levels of panel reactive antibodies have been reduced, and patients have suffered few rejection episodes and no infectious complications. This preliminary experience shows that the addition of photochemotherapy to conventional regimens may improve the clinical course of hypersensitized transplant patients without additional immunosuppressive risk.
authors.affiliation: Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, N.Y. 10032.
authors.forename: E A
authors.initials: EA
authors.lastname: Rose
authors.forename: M L
authors.initials: ML
authors.lastname: Barr
authors.forename: H
authors.initials: H
authors.lastname: Xu
authors.forename: P
authors.initials: P
authors.lastname: Pepino
authors.forename: M P
authors.initials: MP
authors.lastname: Murphy
authors.forename: M A
authors.initials: MA
authors.lastname: McGovern
authors.forename: A J
authors.initials: AJ
authors.lastname: Ratner
authors.forename: J F
authors.initials: JF
authors.lastname: Watkins
authors.forename: C C
authors.initials: CC
authors.lastname: Marboe
authors.forename: C L
authors.initials: CL
authors.lastname: Berger
mesh_terms: D000328:Adult; D003601:Cytotoxicity Tests, Immunologic; D005260:Female; D006084:Graft Rejection / Q000276:immunology*; D016027:Heart Transplantation / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007167:Immunotherapy / Q000379:methods*; D007937:Leukapheresis; D008875:Middle Aged; D010778:Photochemotherapy; D012307:Risk Factors
chemical_list: D007166:Immunosuppressive Agents