ECP for subclinical AMR after lung transplantation: a RCT

Lung transplantation can be a life-saving procedure, but long-term success is often threatened by the body`s immune system rejecting the new lung, both in the short term and over the long term. One of the key factors in this rejection process is the presence of antibodies and a condition known as antibody-mediated rejection. Unfortunately, there are currently no effective treatments for these conditions, especially when they occur without obvious signs of lung problems, as available treatments can cause severe side effects. Recent research from our medical center suggests that a treatment called extracorporeal photopheresis (ECP) might offer a safer alternative. ECP is a process where a patients blood is treated with ultraviolet light after being mixed with a photoactivating agent. Our initial findings showed that ECP might reduce the level of antibodies, and because it has relatively few side effects, ECP could be a good option for treating patients who have this condition, but the lung still functions well. The main hypothesis of our study is that ECP is a safe and effective way to treat subclinical AMR in lung transplant patients with DSAs. To test this hypothesis, we are conducting a clinical study involving 80 lung transplant patients who have persistent antibodies but no signs of lung problems. These patients will be randomly divided into two groups: one group will receive ECP treatment, while the other will be monitored without immediate intervention. The main goal of this study is to see if ECP can reduce the levels of antibodies after six months compared to the levels before treatment began. Additionally, we will examine how ECP affects the immune system. This study could be groundbreaking by offering a new, safer way to manage subclinical AMR in lung transplant recipients, potentially reducing the risk of severe rejection and helping patients maintain better long-term health.