Extracorporeal photopheresis and its role in heart transplant rejection: prophylaxis and treatment

Sharon Slomovich, Jennifer Bell, Kevin J. Clerkin, Marlena V. Habal, Jan M. Griffin, Jayant K. Raikhelkar, Justin A. Fried, Sarah R. Vossoughi, Katie Finnigan, Farhana Latif, Maryjane A. Farr, Gabriel T. Sayer, Nir Uriel

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations

Abstract

Heart transplantation is the gold standard therapeutic option for select patients with end-stage heart failure. Unfortunately, successful long-term outcomes of heart transplantation can be hindered by immune-mediated rejection of the cardiac allograft, specifically acute cellular rejection, antibody-mediated rejection, and cardiac allograft vasculopathy. Extracorporeal photopheresis is a cellular immunotherapy that involves the collection and treatment of white blood cells contained in the buffy coat with a photoactive psoralen compound, 8-methoxy psoralen, and subsequent irradiation with ultraviolet A light. This process is thought to cause DNA and RNA crosslinking, ultimately leading to cell destruction. The true mechanism of therapeutic action remains unknown. In the last three decades, extracorporeal photopheresis has shown promising results and is indicated for a variety of conditions. The American Society for Apheresis currently recommends the use of extracorporeal photopheresis for the treatment of cutaneous T-cell lymphoma, scleroderma, psoriasis, pemphigus vulgaris, atopic dermatitis, graft-versus-host disease, Crohn's disease, nephrogenic systemic fibrosis, and solid organ rejection in heart, lung, and liver transplantation. In this review, we aim to explore the proposed effects of extracorporeal photopheresis and to summarize published data on its use as a prophylactic and therapy in heart transplant rejection.

Original languageEnglish (US)
Article numbere14333
JournalClinical Transplantation
Volume35
Issue number7
DOIs
StatePublished - Jul 2021
Externally publishedYes

Keywords

  • acute cellular rejection
  • acute rejection
  • antibody-mediated rejection
  • cardiac allograft vasculopathy
  • chronic rejection
  • extracorporeal photopheresis
  • heart transplantation

ASJC Scopus subject areas

  • Transplantation

Fingerprint

Dive into the research topics of 'Extracorporeal photopheresis and its role in heart transplant rejection: prophylaxis and treatment'. Together they form a unique fingerprint.

Cite this