Extracorporeal Photopheresis Improves Survival Probability and Lowers Hospital-Related Expenses In Lung Transplant Recipients With Bronchiolitis Obliterans Syndrome

Abstract

Purpose Extracorporeal photopheresis (ECP) is used at the Medical University of Vienna as an empiric treatment option for lung transplant recipients suffering from bronchiolitis obliterans syndrome (BOS). The objective of the present retrospective investigation was to evaluate hospital-related costs and the clinical value of ECP when applied as an adjunct to the local standard therapy of BOS compared to standard treatment alone. Methods The patient population consisted of 32 double-lung transplant recipients who had been diagnosed with BOS. Sixteen matched pairs, each pair comprising of one ECP-treated patient and one control patient was built (matched population). Preselect pair-match criteria were weighted. The primary matching criterion was the BOS grade at diagnosis. Secondary matching factors were the year of transplantation, age at transplantation, and gender. Results Study groups were identical in demographic characteristics and clinical parameters at baseline. Over the observation period of up to 15.5 years, survival probability was improved by approximately 30% in the ECP treated patients as compared to matched controls (see Figure A; p Conclusion Compared to standard BOS-directed therapies, ECP improves significantly survival probability in double-lung transplant patients diagnosed with BOS. ECP exerts a significant impact on the number of total re-admissions to the hospital, the total days of care, and the total patient days. Thus, ECP has proved highly effective and cost saving in the treatment of lung transplant patients presenting with BOS.