Division of Pulmonary & Critical Care Medicine, Washington University School of Medicine/Barnes-Jewish Hospital, St. Louis, Missouri 63110, USA.
J Heart Lung Transplant. 2010 Apr;29(4):424-31. doi: 10.1016/j.healun.2009.08.029. Epub 2009 Oct 22.
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.
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.
During the 6-month period before the initiation of ECP, the average rate of decline in forced expiratory volume in 1 second (FEV(1)) 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 FEV(1) improved in 25.0% of patients after the initiation of ECP, with a mean increase of 20.1 ml/month.
ECP is associated with a reduction in the rate of decline in lung function associated with progressive BOS.
体外光化学疗法（ECP）已被用于治疗实体器官移植后的急性和慢性排斥反应。然而，支持 ECP 用于肺移植后闭塞性细支气管炎综合征（BOS）的数据有限。
我们回顾性分析了本机构中 ECP 治疗进展性 BOS 的疗效和安全性。2000 年 1 月 1 日至 2007 年 12 月 31 日期间，有 60 例肺移植受者因进展性 BOS 接受了 ECP 治疗。
在开始 ECP 前的 6 个月期间，用力呼气量（FEV1）的平均下降率为-116.0ml/月，但在开始 ECP 后的 6 个月期间，斜率下降至-28.9ml/月，下降率的平均差异为 87.1ml/月（95%置信区间，57.3-116.9；p<0.0001）。在开始 ECP 后，有 25.0%的患者的 FEV1 得到改善，平均每月增加 20.1ml。
ECP 与进展性 BOS 相关的肺功能下降率降低有关。
