Photopheresis

Gosh its cold.

It was 8c in my lounge when I got up this morning….It only went up to 12c with the heating full on for 30 minutes! Cold doesn’t help me and I may leave the heater on all night from now on…..It was –5c when I got to work outside the car…

It would freeze the balls off a brass monkey.

I am still looking for the treatment for chronic rejection on the net so I go to my outpatients in Newcastle next week with knowledge and a plan! Check out ATG and photopheresis in Google...


ADJUVANT TREATMENT OF REFRACTORY LUNG TRANSPLANT REJECTION WITH EXTRACORPOREAL
PHOTOPHERESIS


Background: Extracorporeal photopheresis is an immunomodulatory technique
in which a patient's leukocytes are exposed to ultraviolet-A light after
pretreatment with 8-methoxypsoralen (methoxsalen). There have been few reports
describing the use of extracorporeal photopheresis in lung transplant recipients.

Methods: We reviewed our experience using extracorporeal photopheresis in
8 lung transplant recipients since 1992. All 8 patients had progressively
decreasing graft function and 7 were in bronchiolitis obliterans syndrome
grade 3 before the initiation of photopheresis.

One patient had undergone a second transplant operation for obliterative bronchiolitis. Two patientshad a pretransplantation diagnosis of chronic obstructive pulmonary disease,1 1-antitrypsin deficiency, 1 cystic fibrosis, 1 bronchiectasis, 1 idiopathicpulmonary fibrosis, and 2 primary pulmonary hypertension. Before refractory
rejection developed, all patients had been treated with 3-drug immunosuppression
and anti-T-cell therapy. The median time from transplantation to the start
of extracorporeal photopheresis was 16.5 months and the median number of
treatments was 6.

Results: The condition of 5 of 8 patients subjectively improved after extracorporeal
photopheresis therapy. In these 5 patients photopheresis was associated with
stabilization of the forced expiratory volume in 1 second. In 2 patients
there was histologic reversal of rejection after photopheresis.