Outcomes Following Extracorporeal Photopheresis for Chronic Lung Allograft Dysfunction Following Lung Transplantation: A Single-Center Experience.


Journal

Transplantation proceedings
ISSN: 1873-2623
Titre abrégé: Transplant Proc
Pays: United States
ID NLM: 0243532

Informations de publication

Date de publication:
Historique:
received: 26 03 2020
revised: 15 08 2020
accepted: 06 09 2020
pubmed: 12 10 2020
medline: 20 4 2021
entrez: 11 10 2020
Statut: ppublish

Résumé

Survival following lung transplantation (LTx) is limited by the development of chronic lung allograft dysfunction (CLAD), for which there are few effective therapies and no standardized management. Several small studies have demonstrated the effectiveness of extracorporeal photopheresis (ECP) as a therapeutic option for CLAD. A retrospective descriptive audit of 12 LTx recipients who received rescue ECP for CLAD over 5 years (2013-2018) at the Alfred Hospital, Melbourne, Australia, was completed. Nonresponders to ECP were defined as patients who experienced a 20% decrease in forced expiratory volume (FEV Mean time since LTx was 849 days and mean time since diagnosis of CLAD was 131 days. Fifty-eight percent of patients were male (n = 7) and 67% responded to ECP therapy (n = 8). Among responders, the mean (95% confidence interval) decline in FEV Rescue ECP arrested the decline of lung function in 67% of patients with CLAD. Sex, pre-ECP neutrophil count, and exposure to anti-thymocyte globulin may help determine response to ECP. Future clinical trials are needed to confirm this effect, help predict response to therapy, and ultimately guide the placement of ECP in the treatment algorithm for CLAD.

Identifiants

pubmed: 33039145
pii: S0041-1345(20)30587-X
doi: 10.1016/j.transproceed.2020.09.003
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

296-302

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Jaideep Vazirani (J)

Department of Respiratory Medicine, The Alfred Hospital, Melbourne, Victoria, Australia. Electronic address: jaideepvazirani55@gmail.com.

David Routledge (D)

Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia.

Greg I Snell (GI)

Department of Respiratory Medicine, The Alfred Hospital, Melbourne, Victoria, Australia.

Doug Watson (D)

Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia.

Miranda Paraskeva (M)

Department of Respiratory Medicine, The Alfred Hospital, Melbourne, Victoria, Australia.

Glen P Westall (GP)

Department of Respiratory Medicine, The Alfred Hospital, Melbourne, Victoria, Australia.

Simon J Harrison (SJ)

Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia.

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