Extracorporeal photopheresis for the treatment of lung allograft rejection.
OBJECTIVE
Acute and chronic rejection continue to limit the survival of lung transplant recipients. Extracorporeal photopheresis has evolved as a possible therapy for patients with acute nd chronic lung allograft rejection.


METHODS
We retrospectively reviewed 14 patients diagnosed with BOS who underwent therapy with extracorporeal photopheresis.


RESULTS
Three patients were classified as BOS 0'b', five as BOS 1, three as BOS 2, and, three as BOS 3 at the time of diagnosis. Of the patients with BOS 0'b' or BOS 1 seven remain alive and one died of lung cancer. Two have progressed to BOS 2. Of the patients with BOS 2 or 3, four have died of BOS, one died of lung cancer, and one was re-transplanted. In three patients with BOS and concurrent acute rejection, therapy with extracorporeal photopheresis led to the resolution of the acute rejection episode. Two of the 14 patients developed line related sepsis.


CONCLUSIONS
Extracorporeal photopheresis appears to be a promising therapy for patients with early BOS. It may also have a role in the treatment of acute lung allograft rejection.
Villanueva
J
J
Division of Pulmonary and Critical Care Medicine, Loyola University Medical Center, 2160 South First Avenue, Maywood, Illinois 60153, USA.
Bhorade
S M
SM
Robinson
J A
JA
Husain
A N
AN
Garrity
E R
ER
D000208:Acute Disease; D000328:Adult; D001989:Bronchiolitis Obliterans / Q000188:drug therapy / Q000209:etiology; D002908:Chronic Disease; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D017893:Photopheresis