Extracorporeal photochemotherapy treatment for acute lung rejection episode.
METHODS
We investigated extracorporeal photochemotherapy--which consists of the collection of blood mononuclear cells by means of a cell separator, their exposure to ultraviolet A light in the presence of a photoactivatable molecule such as 8-methoxypsoralen, and their intravenous reinjection into the patient--for the treatment of an acute lung rejection episode in a severely infected patient, assuming that its mechanism of action is an immunomodulation rather than an actual immunosuppression.


RESULTS
Three weeks after the simultaneous beginning of antiinfectious and extracorporeal photochemotherapy treatments, the patient improved clinically. Acute lung rejection was no longer detectable histologically 4 weeks after the beginning of extracorporeal photochemotherapy. Twenty-two months after the beginning of extracorporeal photochemotherapy (47 months after transplantation), the patient was living a normal life.


CONCLUSIONS
We believe this treatment may be considered for further studies not only in acute lung rejection therapy when intensive immunosuppression is contraindicated but also as a means of rejection prevention.
Andreu
G
G
Blood Bank, Hôtel-Dieu Hospital, Broussais, France.
Achkar
A
A
Couetil
J P
JP
Guillemain
R
R
Heshmati
F
F
Amrein
C
C
Chevalier
P
P
Guinvarch
A
A
Dore
M F
MF
Capron
F
F
D002469:Cell Separation; D003131:Combined Modality Therapy; D005112:Extracorporeal Circulation; D006084:Graft Rejection / Q000188:drug therapy*; D016041:Heart-Lung Transplantation; D006801:Humans; D006976:Hypertension, Pulmonary / Q000601:surgery*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008213:Lymphocyte Activation / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D011701:PUVA Therapy; D012008:Recurrence; D013601:T-Lymphocytes / Q000187:drug effects
D007166:Immunosuppressive Agents