Extracorporeal Photopheresis in Lung Transplantation - New Frontiers in Infection Immunomodulation - A Case Series

PurposeLung transplantation outcomes are limited by chronic lung allograft dysfunction (CLAD). Infection driven loss of graft function is a common cause CLAD. Extracorporeal photopheresis (ECP) salvage therapy post with the indications broadening as experience and availability increases. The therapeutic role ECP yet to be explored in infection CLAD.MethodsA retrospective audit all transplant recipients at single UK centre who received from 2017 2021 was performed using electronic records.5 patients CLAD treated were identified.Results40% male median(range) age 63(30-70) years. Median duration 38(13-53)months median 14(10-15) months. All 5 responders 2 months (defined less than 20 percent FEV1 fall). Median(range) percentage change improved -17% (-20 to+10%) one year pre-ECP +1%(-1to+10%) post-ECP (Figure1). Mycophenolate mofetil stopped for on initiation ECP. 4 had reduction length stay hospital (Figure 2). 3 alive 1 whilst still within their first follow up.ConclusionECP can help stabilize recurrent infections. It allows modification conventional immunosuppression regimens contributes quality life decreasing number antibiotic days. Lung A identified. 40% up.