EXTRACORPOREAL PHOTOCHEMOTHERAPY TREATMENT FOR ACUTE LUNG REJECTION EPISODE

Background and Methods: We investigated extracorporeal photochemothera py - which consists of the collection of blood mononuclear cells by me ans of a cell separator, their exposure to ultraviolet A light in the presence of a photoactivatable molecule such as 8-methoxypsoralen, and their intravenous reinjection into the patient-for the treatment of a n acute lung rejection episode in a severely infected patient, assumin g that its mechanism of action is an immunomodulation rather than an a ctual immunosuppression. Results: Three weeks after the simultaneous b eginning of antiinfectious and extracorporeal photochemotherapy treatm ents, the patient improved clinically. Acute lung rejection was no lon ger detectable histologically 4 weeks after the beginning of extracorp oreal photochemotherapy. Twenty-two months after the beginning of extr acorporeal photochemotherapy (47 months after transplantation), the pa tient was living a normal life. Conclusions: We believe this treatment may be considered for further studies not only in acute lung rejectio n therapy when intensive immunosuppression is contraindicated but also as a means of rejection prevention.