Within the first 3 years after a lung transplant, about half of patients experience chronic rejection of the transplanted lung.
Rejection occurs when the body’s immune system reacts against the new lung. This reaction causes narrowing and blockage of the small airways in the lung, which in turn reduces air flow, causes shortness of breath, and can ultimately lead to death. This condition is called “Bronchiolitis Obliterans Syndrome” or “BOS”.
The prevention and treatment of BOS usually starts with medications that suppress the immune system. However, in some patients, the BOS continues to worsen despite changes in the type and dose of the anti-rejection medications. At some centers, a procedure called Extracorporeal Photopheresis (ECP) has been used to treat progressive BOS, with favorable clinical results in many patients. With ECP, a special machine draws out blood from a patient through a catheter (small plastic tube) which is placed into a vein. The machine treats the white blood cells with both a medication (psoralen) and ultraviolet light, then returns them back into the patient through the catheter. Studies to date suggest that ECP is often effective in preventing further lung damage from BOS.
However, doctors would like to know which patients with BOS are most likely to benefit from ECP. The purpose of this study is to record the results of ECP treatment in 240 patients from 20+ hospitals around the country, in order to determine which patients benefit and what factors affect the response to this therapy.