Successful reversal of severe refractory cardiac allograft rejection by photopheresis

We treated 4 patients with refractory International Society of Heart and Lu ng Transplantation Grades IIIA to IV cardiac allograft rejection with extra corporeal photopheresis. Following treatment on 2 consecutive days, 3 patie nts demonstrated complete histologic reversal of rejection. The remaining p atient improved more gradually, but manifested complete cessation of reject ion following three 2-day treatments. We conclude that photopheresis is a s afe and effective modality for the treatment of severe refractory cardiac a llograft rejection and that these results support the use of photopheresis in this clinical setting.