Journal article
ECP as additional immunomodulation in idiopathic hyperammonemia and recurrent hypercapnic respiratory failure early post lung transplantation.
- Steinack C Pulmonology, University Hospital Zurich, Zurich, Switzerland.
- Robinson CA Pulmonology, University Hospital Zurich, Zurich, Switzerland.
- Nägeli M Dermatology, University Hospital Zurich, Zurich, Switzerland.
- Inci I Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland.
- Benden C Pulmonology, University Hospital Zurich, Zurich, Switzerland.
- 2020-08-25
Published in:
- Journal of clinical apheresis. - 2020
English
Extra-corporeal photopheresis (ECP) is known as safe ultimate treatment option for chronic lung allograft dysfunction (CLAD). Here, we report the first case of ECP as "second-line" immunomodulatory therapy early post-transplant in an adult patient undergoing lung transplantation for severe chronic thromboembolic pulmonary hypertension, complicated by impaired consciousness due to idiopathic hyperammonemia resulting in recurrent hypercapnic respiratory failure. ECP was initiated twice weekly on post-transplant day 25 and standard triple immunosuppression reduced. Within 2 weeks, the clinical status improved. ECP has been continued every 4 weeks after discharge. At 1 year post-transplant, ECP was stopped as maintenance immunosuppression was reached. We recommend to consider the immunomodulatory effect of ECP as "second line" immunomodulatory therapy in cases where standard immunosuppression causes severe collateral damage. ECP is able to assist prevention of allograft rejection in conjunction with reduced levels of standard immunosuppression, even in the early period following lung transplantation.
- Language
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- English
- Open access status
- closed
- Identifiers
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- DOI 10.1002/jca.21831
- PMID 32838480
- Persistent URL
- https://sonar.ch/global/documents/47731
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