Characteristics of photopheresis treatments for the management of rejection in heart and lung transplant recipients.
J Clin Apher
; 17(1): 27-32, 2002.
Article
em En
| MEDLINE
| ID: mdl-11948703
ABSTRACT
Photopheresis has been used in the management of rejection of heart and/or lung transplants. Although its mechanism of action remains unknown, irradiated T-helper cell-induced immunosuppression is the main theory. Since transplant recipients are often lymphopenic and lymphocytes are the target cells in phototherapy, we performed this study to determine which factors affect the cellular yield to undergo irradiation. We reviewed the records of all photophereses performed in our institution between July 1998 and April 2000 using the UVAR (first generation) or XTS (second generation) instruments (Therakos, Exton, PA). Our data included patient's blood volume, absolute lymphocyte count and hematocrit, catheter type, flow rate of collection cycles and centrifuge bowl size, as well as volume, hematocrit, and lymphocyte count of the cell suspension. With a mixed model multivariate analysis we sought to determine which variables predicted the lymphocyte yield. A total of 406 procedures in 25 adult patients was analyzed. There was no significant difference between the lymphocyte yield among the procedures performed with the first- and the second-generation instruments. The patient's absolute lymphocyte count was the only parameter, which positively correlated with the total number of lymphocytes collected for irradiation (P < 0.0001). Indeed, based on the mixed model, the total number of lymphocytes for irradiation can be predicted from the pre-procedure lymphocyte count. Additional studies are necessary to correlate the number of treated cells with patient outcome.
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Base de dados:
MEDLINE
Assunto principal:
Transplante de Coração-Pulmão
/
Transplante de Coração
/
Terapia de Imunossupressão
/
Transplante de Pulmão
/
Fotoferese
/
Rejeição de Enxerto
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
J Clin Apher
Ano de publicação:
2002
Tipo de documento:
Article
País de afiliação:
Estados Unidos