Successful reversal of recalcitrant hepatic allograft rejection by photopheresis.
Extracorporeal photopheresis (ECP) is an immunologic modality that has shown efficacy in the treatment of clonal T-cell diseases, including Sézary syndrome and allograft rejection. In this case report, we expand on this observation to include recalcitrant hepatic allograft rejection. A 14-year-old boy with hepatic allograft rejection refractory to high-dose corticosteroid and lymphocytolytic therapy was treated with 4 sessions of ECP over a 6-week period. After 2 sessions, a liver biopsy showed complete reversal of acute cell-mediated rejection. No opportunistic infections or other adverse events were noted. Photopheresis appears to be a safe and effective modality for the treatment of refractory hepatic allograft rejection.
Lehrer
M S
MS
Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
Ruchelli
E
E
Olthoff
K M
KM
French
L E
LE
Rook
A H
AH
D000293:Adolescent; D006084:Graft Rejection / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008099:Liver / Q000473:pathology; D016031:Liver Transplantation; D008297:Male; D017893:Photopheresis; D012074:Remission Induction