Extrakorporale Photopherese bei der Transplantation solider Organe

Die extrakorporale Photopherese (ECP) ist ein seit fast 4 Jahrzehnten etabliertes immunmodulatorisches Aphereseverfahren. Ursprünglich zur Therapie des kutanen T-Zell-Lymphoms entwickelt, hat sie sich als adjuvante oder alternative Behandlung bei Transplantatabstoßungen solider Organe bewährt. Aktuelle Studien zeigen insbesondere bei Herz- und Lungentransplantierten eine signifikante Reduktion akuter und chronischer Rejektionsereignisse bei guter Verträglichkeit.

Abstract

Extracorporeal Photopheresis (ECP) represents an immunomodulatory treatment. During ECP, mononuclear cells are separated from peripheral blood and incubated with 8-MOP. Thereafter these cells are irradiated with UVA and reinfused into the patient. ECP treatment has been clinically established for more than 30 years and is generally very well tolerated. ECP has been used long-term for the treatment of cutaneous T-cell lymphomas, acute and chronic GvHD. Beyond that, it is a therapeutic modality for prophylaxis and treatment of solid organ rejection, too. There is good evidence regarding the efficacy of ECP in prevention and treatment of rejection after heart transplantation. The usefulness of ECP in the treatment of chronic rejection after lung transplantation has been reported in retrospective trials and recently also in prospective randomized studies. To date, there are only case reports regarding therapeutic efficacy of ECP in the rejection after kidney transplantation. ECP could be a valuable complementary component of therapeutic protocols for prophylaxis and treatment of acute rejection following liver transplantation. Nevertheless, prospective controlled trials are urgently needed to support systematic application of ECP in these indications.

Schlüsselwörter

extrakorporale Photopherese - Organtransplantation - Immunmodulation

Keywords

extracorporeal photopheresis - organ transplantation - immunomodulation

• Literatur

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