The efficacy of photopheresis for bronchiolitis obliterans syndrome after lung transplantation

Matthew R. Morrell, George J. Despotis, Douglas M. Lublin, George A. Patterson, Elbert P. Trulock, Ramsey R. Hachem

Research output: Contribution to journalArticlepeer-review

156 Scopus citations

Abstract

Background: Extracorporeal photopheresis (ECP) has been used to treat acute and chronic rejection after solid organ transplantation. However, data supporting the use of ECP for bronchiolitis obliterans syndrome (BOS) after lung transplantation are limited. Methods: We retrospectively analyzed the efficacy and safety of ECP for progressive BOS at our institution. Between January 1, 2000, and December 31, 2007, 60 lung allograft recipients were treated with ECP for progressive BOS. Results: During the 6-month period before the initiation of ECP, the average rate of decline in forced expiratory volume in 1 second (FEV1) was -116.0 ml/month, but the slope decreased to -28.9 ml/month during the 6-month period after the initiation of ECP, and the mean difference in the rate of decline was 87.1 ml/month (95% confidence interval, 57.3-116.9; p < 0.0001). The FEV1 improved in 25.0% of patients after the initiation of ECP, with a mean increase of 20.1 ml/month. Conclusions: ECP is associated with a reduction in the rate of decline in lung function associated with progressive BOS.

Original languageEnglish
Pages (from-to)424-431
Number of pages8
JournalJournal of Heart and Lung Transplantation
Volume29
Issue number4
DOIs
StatePublished - Apr 2010

Keywords

  • bronchiolitis obliterans syndrome
  • chronic rejection
  • extracorporeal
  • lung function
  • photopheresis

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