title: A prospective interventional study on the use of extracorporeal photopheresis in patients with bronchiolitis obliterans syndrome after lung transplantation.
abstract: BACKGROUND
  The aim of this prospective study was to evaluate the efficacy and safety of extracorporeal photopheresis (ECP) in patients with bronchiolitis obliterans syndrome (BOS) after lung transplantation and to identify factors predicting treatment response.
  
  
  METHODS
  The study was performed at a single center and consisted of a cohort of 1,012 lung transplant recipients (November 1989-June 2010). A total of 194 patients developed BOS after a mean of 1,293 ± 1,008 days (range, 99-4,949 days) and received established treatment, and 51 patients received additional ECP.
  
  
  RESULTS
  Thirty-one (61%) of the ECP-treated patients responded to the therapy and showed sustained stabilization (forced expiratory volume in 1 second range, -5% to 5% vs baseline at start of ECP) of lung function over 6 months. Responders to ECP showed significantly greater survival and less need for retransplantation (p = 0.001) than non-responders. Factors associated with an inferior treatment response were cystic fibrosis as underlying lung disease and a longer time between transplantation and development of BOS. No side effects were observed after ECP. Compared with BOS patients not treated with ECP, the ECP responders showed an improved graft survival (p = 0.05).
  
  
  CONCLUSIONS
  These results confirm and suggest that early use of ECP could be an effective adjunct treatment for patients who develop BOS after lung transplantation.
authors.affiliation: Department of Thoracic Surgery, University Hospital Vienna, Vienna, Austria. peter.jaksch@meduniwien.ac.at
authors.forename: Peter
authors.initials: P
authors.lastname: Jaksch
authors.forename: Axel
authors.initials: A
authors.lastname: Scheed
authors.forename: Maya
authors.initials: M
authors.lastname: Keplinger
authors.forename: Mai-Britt
authors.initials: MB
authors.lastname: Ernst
authors.forename: Theresa
authors.initials: T
authors.lastname: Dani
authors.forename: Ulrike
authors.initials: U
authors.lastname: Just
authors.forename: Hesam
authors.initials: H
authors.lastname: Nahavandi
authors.forename: Walter
authors.initials: W
authors.lastname: Klepetko
authors.forename: Robert
authors.initials: R
authors.lastname: Knobler
mesh_terms: D001989:Bronchiolitis Obliterans / Q000209:etiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D017893:Photopheresis; D011446:Prospective Studies; D013577:Syndrome