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Lookup NU author(s): Professor Andrew FisherORCiD, Professor Andrew GenneryORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Copyright © 2025 Cashmore, Barten, Diekmann, Epailly, Fisher, Gennery, Gibbons, Gökler, Guest, Heng, Hutchinson, Rampino, Vos and Potena.Solid organ transplantation (SOT) faces significant challenges in managing allograft rejection, with current immunosuppressive therapies often associated with substantial adverse effects. Extracorporeal photopheresis (ECP) has emerged as a promising adjunctive treatment for rejection prevention and management in heart and lung transplants, with growing evidence supporting its use in kidney and liver transplants. Despite this, the availability of ECP and its place in standard treatment pathway is widely variable across Europe. This narrative review, supported by a European survey of 51 transplant clinicians, highlights the current usage of ECP in SOT. Findings reveal that ECP is primarily used for recurrent rejection in heart and lung transplants, with limited application currently in kidney and liver transplants. ECP has shown some efficacy in managing acute and chronic rejection, and stabilizing graft function. Barriers including lack of standardized protocols, availability of ECP, lack of high-quality clinical trial data and lack of a defined mechanism of action hinder its broader adoption. Future directions include the development of standardized protocols, multicenter registries, and further controlled clinical trials to define the role of ECP. Increased awareness, cost-effectiveness studies, mechanistic studies and equitable access are essential to integrate ECP into routine SOT management.
Author(s): Cashmore S-J, Barten MJ, Diekmann F, Epailly E, Fisher AJ, Gennery AR, Gibbons B, Gokler J, Guest J, Heng A-E, Hutchinson JA, Rampino T, Vos R, Potena L
Publication type: Review
Publication status: Published
Journal: Transplant International
Year: 2025
Volume: 38
Online publication date: 03/11/2025
Acceptance date: 22/09/2025
ISSN (print): 0934-0874
ISSN (electronic): 1432-2277
Publisher: Frontiers Media SA
URL: https://doi.org/10.3389/ti.2025.14906
DOI: 10.3389/ti.2025.14906
PubMed id: 41256739
