Extracorporeal photopheresis as second-line treatment therapy in life-threatening primary graft dysfunction following lung transplantation

ECP is an established second-line treatment for CLAD/BOS. Recently, ECP was used for the first time in an adolescent CF patient as a second-line treatment therapy in life-threatening primary graft dysfunction following lung transplantation who deteriorated despite extensive treatment including ECMO and ATG. Within 10days after initiation of ECP twice weekly, allograft function and clinical status improved significantly and the patient was weaned from mechanical ventilation support. ECP has been continued every 2 weeks since. Two hundreddays after lung transplantation, the patient has an acceptable allograft function (FEV1 67%) and no signs of allograft rejection. We advocate that use of ECP and its immunomodulatory effects should be evaluated in the early period following lung transplantation.