Renal transplantationImmunosuppresive therapyExtracorporeal Photopheresis as an Antirejection Prophylaxis in Kidney Transplant Recipients: Preliminary Results
Section snippets
Selection and Description of Participants
Twenty consecutive kidney allograft recipients who received kidneys from 10 cadaveric donors (10 pairs) were assigned to the ECP-treated or the control group. Selection was based on ECP exclusion criteria and declared patient adherence to study visits over at least 12 months post-KTx. If both initial criteria were met, we performed a randomization. The ECP group underwent 12 to 16 ECP procedures in the first 3 months following KTx. Control and ECP subjects were prescribed mycophenolate mofetil
Results
Biopsy-proven acute rejection appeared in one control group recipient. The ECP group showed a positive tendency to a higher eGFR at months 3 (53 ± 11 vs 47.1 ± 9 mL/min/1.73 m2; P = .17) and a significant difference at 6 months (67.5 ± 10 vs 53.6 ± 3 mL/min/1.73 m2; P = .03 in Wilcoxon test; (Table 1).
Increased percentages of Treg (CD3+ CD4+ CD25+) in the total CD3 cell count (4.9% ± 1% to 9.4% ± 15%) as well as among inducible Treg (CD3+ CD8+ CD28−) among CD3 cells (3.3% ± 3% to 11.8% ± 8%; P
Discussion
Currently available immunosuppressive drugs are associated with severe complications such as hypertension, diabetes mellitus, infectious risk, and malignancies. Often they do not present episodes of rejection. New, less-toxic immunologic measures are needed to reduce the side effects. ECP has been shown to benefit patients with cardiac,3 but also kidney transplantations. A few reports have suggested that ECP serves as an effective “rescue” therapy for kidney rejection episodes resistant to
References (11)
- et al.
Extracorporeal photopheresis: from solid organs to face transplantation
Transpl Immunol
(2009) - et al.
Refractory acute renal allograft rejection successfully treated with photopheresis
Transplant Proc
(2005) - et al.
Intravenous infusion of syngeneic apoptotic cells by photopheresis induces antigen-specific regulatory T cells
J Immunol
(2005) - et al.
Photopheresis for the prevention of rejection in cardiac transplantationPhotopheresis Transplantation Study Group
N Engl J Med
(1998) - et al.
Successful treatment of recurrent rejection in renal transplant patients with photopheresis
J Am Soc Nephrol
(1998)
Cited by (0)
This work was supported by the Ministry of Science and Higher Education (MNiSW, Poland, Grant No. N402 178934).