| Potential applications of extracorporeal photopheresis in liver transplantation. | |
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MedLine Citation:
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PMID: 18555142 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Extracorporeal photopheresis (ECP) is an immunomodulatory therapy performed through a temporary peripheral venous access with documented efficacy in heart and renal transplantation. We originally reported that ECP represented a valuable alternative to treat graft rejection in selected liver transplant (OLT) recipients. We have investigated potential applications of ECP for prophylaxis of allograft rejection. The first field explored was the use of ECP for delayed introduction of calcineurin inhibitors (CNI) among high-risk OLT recipients seeking to avoid CNI toxicity. In 42 consecutive patients that we assigned to prophylaxis with ECP, we were able to delay CNI introduction after postoperative day 8 in one-third of them. The second field was the use of ECP for prophylaxis of acute cellular rejection among ABO-incompatible OLT recipients. In our experience, none of 11 patients treated with ECP developed a cell-mediated rejection. The third field was ECP application in hepatitis C virus-positive patients seeking to reduce the immunosuppressive burden and improve sustainability and efficacy of preemptive antiviral treatment with interferon and ribavirin. Among 78 consecutive patients, we were able to start preemptive antiviral treatment in 69.2% of them at a median time from OLT of 14 days (range = 7 to 130 days). Thirty-six (66.7%) patients completed the treatment course with an end of treatment virological response of 50.0% and a sustained virological response of 38.9%. These preliminary results await validation in larger prospective studies with longer follow-up periods. |
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Authors:
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L Urbani; A Mazzoni; P Colombatto; G Biancofiore; L Bindi; C Tascini; F Menichetti; M Brunetto; F Scatena; F Filipponi |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Transplantation proceedings Volume: 40 ISSN: 0041-1345 ISO Abbreviation: Transplant. Proc. Publication Date: 2008 May |
Date Detail:
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Created Date: 2008-06-16 Completed Date: 2008-08-07 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 0243532 Medline TA: Transplant Proc Country: United States |
Other Details:
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Languages: eng Pagination: 1175-8 Citation Subset: IM |
Affiliation:
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Liver Transplant Unit, Azienda Ospedaliero-Universitaria Pisana, Ospedale Cisanello, Pisa, Italy. lucio.urbani.68@alice.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Calcineurin
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antagonists & inhibitors Graft Rejection / prevention & control* Humans Immunotherapy / methods* Liver Transplantation / immunology* Photopheresis / methods* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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EC 3.1.3.16/Calcineurin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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