Successful treatment of recurrent rejection in renal transplant patients with photopheresis.

Journal of the American Society of Nephrology : JASN
R Dall'AmicoF Zacchello

Abstract

Photopheresis (ECP) is a new form of photochemotherapy that induces a selective inhibition of the host response to foreign histocompatibility antigens and reverses allograft rejection after organ transplantation. This report describes four adolescent patients with recurrent rejection episodes after renal transplantation, all uncontrolled using standard protocols of immunosuppression (intravenous steroids and OKT3), yet successfully treated with a 6-mo course of ECP. The ECP treatment was performed at weekly intervals during the first month, at 2-wk intervals during the second and third months, and then monthly for another 3 mo. Creatinine clearance improved throughout the treatment in three patients and remained unchanged in one. All patients had a pre-ECP biopsy with a grade 2 or 3 rejection (Banff) with a diffuse infiltrate CD8, CD14, LFA-1 (166 cells positive/0.048 mm2), and VLA-4 (51 cells positive/0.048 mm2) positive, as well as a tubular expression of HLA-DR (6.2 sections of tubule positive/0.048 mm2), ICAM-1, and VCAM-1 (3.1 and 2.9 sections of tubule positive/0.048 mm2). A strong reduction of cell infiltrate and expression of LFA-1 (6.6 cells positive/0.048 mm2). VLA-4 (0.7 cells positive/0.048 mm2), HLA-DR (0.2 section...Continue Reading

Citations

May 16, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Shweta ShahPoyyapakkam Srivaths
May 30, 2001·Transplantation Proceedings·A LegitimoF Mosca
Jun 21, 2001·Blood Reviews·A Oliven, Y Shechter
Jul 20, 2002·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Roberto Dall'Amico, Luisa Murer
May 1, 2001·International Journal of Dermatology·G G Russo, C Mullen
Mar 7, 2003·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Marie-Christine JacobMartine Pernollet
Feb 17, 2005·Transplantation·Gunilla KumlienGunnar Tydén
Nov 22, 2005·Transplantation Proceedings·H GenbergG Tydén
Apr 19, 2006·Journal of Clinical Apheresis·Marisa B Marques, Hande H Tuncer
Jan 1, 2008·Transfusion Medicine and Hemotherapy : Offizielles Organ Der Deutschen Gesellschaft Fur̈ Transfusionsmedizin Und Immunham̈atologie·Paolo Perseghin
May 5, 2009·Transplant Immunology·Mikaël HivelinLaurent Lantieri
Jun 19, 2009·Journal of Clinical Apheresis·Meg J JardineJosette M Eris
Sep 24, 2009·Clinical Immunology : the Official Journal of the Clinical Immunology Society·Vidar RaoTorolf Moen
Oct 13, 2009·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Kristin Baird, Alan S Wayne
Sep 2, 2010·Journal of Clinical Apheresis·Rasheed A BalogunEmaad M Abdel-Rahman
Sep 8, 2011·Journal of Clinical Apheresis·David M Ward

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