Extracorporeal photopheresis in the treatment of cardiac allograft rejection : A single-centre experience
Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved..
Despite novel immunosuppressive (IS) protocols, adverse effects of IS drugs continue to have notable negative impact on patient and cardiac allograft survival after heart transplantation (HTx). Therefore, IS regimens with less toxic side effects are sorely needed. We aimed to evaluate the efficacy of extracorporeal photopheresis (ECP) in combination with tacrolimus-based maintenance IS therapy in the treatment of allograft rejection in adult HTx recipients. Indications for ECP included acute moderate-to-severe or persistent mild cellular rejection, or mixed rejection. Twenty-two patients underwent a median of 22(2-44) ECP treatments after HTx. Median duration of ECP course was 173.5(2-466) days. No relevant adverse effects of ECP were noted. Reduction of methylprednisolone doses was safe throughout the ECP course. ECP, used in conjunction with pharmacological anti-rejection therapy, had a successful reversal of cardiac allograft rejection, decreased the rates of subsequential rejection episodes and normalized the allograft function in patients completing the ECP course. Short- and long-term survivals were excellent (91% at 1 and 5 years post-ECP) and comparable to International Society for Heart and Lung Transplantation registry data on HTx recipient overall survival. In conclusion, ECP can be safely used for the treatment and prevention of cardiac allograft rejection in conjunction with traditional IS regimen.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:79 |
|---|---|
| Enthalten in: |
Transplant immunology - 79(2023) vom: 16. Aug., Seite 101853 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Teszak, Timea [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Cardiac allograft rejection |
|---|
| Anmerkungen: |
Date Completed 19.06.2023 Date Revised 06.03.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.trim.2023.101853 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM356994325 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM356994325 | ||
| 003 | DE-627 | ||
| 005 | 20240306232303.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.trim.2023.101853 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1318.xml |
| 035 | |a (DE-627)NLM356994325 | ||
| 035 | |a (NLM)37196865 | ||
| 035 | |a (PII)S0966-3274(23)00070-9 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Teszak, Timea |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Extracorporeal photopheresis in the treatment of cardiac allograft rejection |b A single-centre experience |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 19.06.2023 | ||
| 500 | |a Date Revised 06.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved. | ||
| 520 | |a Despite novel immunosuppressive (IS) protocols, adverse effects of IS drugs continue to have notable negative impact on patient and cardiac allograft survival after heart transplantation (HTx). Therefore, IS regimens with less toxic side effects are sorely needed. We aimed to evaluate the efficacy of extracorporeal photopheresis (ECP) in combination with tacrolimus-based maintenance IS therapy in the treatment of allograft rejection in adult HTx recipients. Indications for ECP included acute moderate-to-severe or persistent mild cellular rejection, or mixed rejection. Twenty-two patients underwent a median of 22(2-44) ECP treatments after HTx. Median duration of ECP course was 173.5(2-466) days. No relevant adverse effects of ECP were noted. Reduction of methylprednisolone doses was safe throughout the ECP course. ECP, used in conjunction with pharmacological anti-rejection therapy, had a successful reversal of cardiac allograft rejection, decreased the rates of subsequential rejection episodes and normalized the allograft function in patients completing the ECP course. Short- and long-term survivals were excellent (91% at 1 and 5 years post-ECP) and comparable to International Society for Heart and Lung Transplantation registry data on HTx recipient overall survival. In conclusion, ECP can be safely used for the treatment and prevention of cardiac allograft rejection in conjunction with traditional IS regimen | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cardiac allograft rejection | |
| 650 | 4 | |a Extracorporeal photopheresis | |
| 650 | 4 | |a Graft survival | |
| 650 | 4 | |a Heart transplantation | |
| 650 | 4 | |a Immunosuppressive therapy | |
| 650 | 7 | |a Immunosuppressive Agents |2 NLM | |
| 700 | 1 | |a Assabiny, Alexandra |e verfasserin |4 aut | |
| 700 | 1 | |a Kiraly, Akos |e verfasserin |4 aut | |
| 700 | 1 | |a Tarjanyi, Zoltan |e verfasserin |4 aut | |
| 700 | 1 | |a Parazs, Nora |e verfasserin |4 aut | |
| 700 | 1 | |a Szakal-Toth, Zsofia |e verfasserin |4 aut | |
| 700 | 1 | |a Hartyanszky, Istvan |e verfasserin |4 aut | |
| 700 | 1 | |a Szabolcs, Zoltan |e verfasserin |4 aut | |
| 700 | 1 | |a Racz, Kristof |e verfasserin |4 aut | |
| 700 | 1 | |a Reti, Marienn |e verfasserin |4 aut | |
| 700 | 1 | |a Merkely, Bela |e verfasserin |4 aut | |
| 700 | 1 | |a Sax, Balazs |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Transplant immunology |d 1997 |g 79(2023) vom: 16. Aug., Seite 101853 |w (DE-627)NLM07497842X |x 1878-5492 |7 nnns |
| 773 | 1 | 8 | |g volume:79 |g year:2023 |g day:16 |g month:08 |g pages:101853 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.trim.2023.101853 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 79 |j 2023 |b 16 |c 08 |h 101853 | ||