Abstract
Purpose. In 2008, our center reported the first single center experience showing that ECP reduced the rate of lung function decline in patients with bronchiolitis obliterans syndrome (BOS) and stabilized patients with recurrent episodes of acute cellular rejection (ACR). This study cohort was now followed up for additional 5 years.
Methods. Retrospective data analysis. Patients were followed up over a 5-year period from 01/2008 to 12/2012. Phenotyping was based on recently published categories for CLAD. Full lung function data including TLC were available for the full cohort, chest CT in 3/10 patients.
Results. The initial study cohort included 24 patients: 12 treated for BOS, 12 treated for ACR. At the end of the current follow-up period compared to the end of the initial study, 5 patients with BOS were still alive (10/12 at study end), of which one required re-transplantation. 2 BOS patients still underwent ECP at the end of the follow up period, both of which had BOS grade 1 at inclusion. 8 patients treated with ECP for recurrent ACR were still alive at the end of the follow up period (12/12 at study end), no re-transplantation was required and 6 patients still underwent ECP (median 110 cycles, range 60-127). 2 patients stopped ECP upon clinical stabilization. Phenotyping of CLAD showed that all 3 patients with CT data had BOS with air trapping. 1/10 patients (10%) had RAS according to lung function data.
Conclusions. Our long-term follow-up data show that recipients started on ECP at early stages of BOS have a better long-term outcome and, that the subgroup of ECP patients with recurrent ACR has an overall superior survival.
- © 2014 ERS