Use of Extracorporeal Photopheresis in Transplantation of Solid Organs
The rapid development of transplantation medicine, observed over the past several decades around the world, made it possible to provide medical care effectively to patients with terminal diseases of vital organs, who was previously incurable. After transplantation, patients have to take the drugs that suppress the immune response but cause severe side effects throughout their life. Thus, the use of the number of basic immunosuppressive drugs in the early postoperative period is limited due to the presence of renal dysfunction in recipients. The purpose of this review was to systematize and summarize the data concerning the use of extracorporeal photopheresis (ECP, photopheresis) as an alternative variant of immunosuppression in solid organ transplantation. Publications were searched in Pubmed and Google Scholar databases. The analysis included 46 studies of the use of photopheresis in heart, lung, kidney and liver transplantation. A review of published reports showed that ECP is used to prevent and treat heart transplant rejection, as well as lung transplant rejection. Recommendations for the use of photopheresis in liver and kidney transplantation are not described in the literature. However, available studies show that ECP is a relatively effective option for treatment and prevention of kidney transplant rejection, which plays an important role in reducing mortality, episodes of cellular liver transplant rejection, and cases of hepatitis C recurrence, as well as the dose of immunosuppressive drugs.