Nephrology and Renal Transplantation Department, Hospital Clínic de Barcelona, Barcelona, Spain.
Laboratori Experimental de Nefrologia I Trasplantament, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain.
J Clin Apher. 2022 Jun;37(3):197-205. doi: 10.1002/jca.21958. Epub 2021 Dec 22.
The immunomodulatory effects of extracorporeal photopheresis (ECP) have been used for the treatment of T-cell mediated disorders, such as rejection in organ transplantation. Currently, it is an established therapy for heart and lung rejection, but not for kidney transplantation (KT), where experience is limited. In addition, some data suggest that ECP could generate an immune response against infections, thus being an alternative for the treatment of rejection in case of active or high-risk of infection. In the present study, we analyze four cases of use of ECP as concomitant therapy in patients with KT and high risk of opportunistic infections due to the high burden of immunosuppression throughout their renal diseases. Two patients had concomitant viral infection (cytomegalovirus and BK virus, respectively) and three patients were on treatment for graft rejection. In the two patients with active viral infection, the infection was successfully controlled during ECP treatment. In all cases, ECP has been shown to be a safe procedure, without complications.
体外光化学疗法（ECP）的免疫调节作用已被用于治疗 T 细胞介导的疾病，例如器官移植中的排斥反应。目前，它是心脏和肺排斥反应的既定治疗方法，但不适用于肾脏移植（KT），因为经验有限。此外，一些数据表明 ECP 可能会引发针对感染的免疫反应，因此在存在感染或感染风险高的情况下，它是治疗排斥反应的一种替代方法。在本研究中，我们分析了 4 例因肾疾病期间免疫抑制负担过重而具有高机会性感染风险的 KT 患者同时使用 ECP 的情况。2 例患者伴有病毒感染（分别为巨细胞病毒和 BK 病毒），3 例患者正在接受移植物排斥反应的治疗。在 2 例有活动性病毒感染的患者中，ECP 治疗期间成功控制了感染。在所有情况下，ECP 均被证明是一种安全的程序，没有并发症。
