Extracorporeal photopheresis and its role in heart transplant rejection: prophylaxis and treatment

Citations Over TimeTop 14% of 2021 papers

Abstract

Heart transplantation is the gold standard therapeutic option for select patients with end-stage heart failure. Unfortunately, successful long-term outcomes of heart transplantation can be hindered by immune-mediated rejection of the cardiac allograft, specifically acute cellular rejection, antibody-mediated rejection, and cardiac allograft vasculopathy. Extracorporeal photopheresis is a cellular immunotherapy that involves the collection and treatment of white blood cells contained in the buffy coat with a photoactive psoralen compound, 8-methoxy psoralen, and subsequent irradiation with ultraviolet A light. This process is thought to cause DNA and RNA crosslinking, ultimately leading to cell destruction. The true mechanism of therapeutic action remains unknown. In the last three decades, extracorporeal photopheresis has shown promising results and is indicated for a variety of conditions. The American Society for Apheresis currently recommends the use of extracorporeal photopheresis for the treatment of cutaneous T-cell lymphoma, scleroderma, psoriasis, pemphigus vulgaris, atopic dermatitis, graft-versus-host disease, Crohn's disease, nephrogenic systemic fibrosis, and solid organ rejection in heart, lung, and liver transplantation. In this review, we aim to explore the proposed effects of extracorporeal photopheresis and to summarize published data on its use as a prophylactic and therapy in heart transplant rejection.

Related Papers

• → Treatment of severe atopic dermatitis with extracorporeal photopheresis(1994)90 cited
• → Adjuvant treatment of refractory lung transplant rejection with extracorporeal photopheresis(1999)88 cited
• → Vascular access considerations for extracorporeal photopheresis(2018)12 cited
• [Extracorporeal photopheresis as an alternative therapy for drug-resistant graft versus host disease: three cases].(2000)
• → Safety and Outcomes of Extracorporeal Photopheresis with the Therakos Cellex System for Graft Versus Host Disease in Pediatric Patients(2014)1 cited