Successful reversal of recalcitrant hepatic allograft rejection by photopheresis

Extracorporeal photopheresis (ECP) is an immunologic modality that has shown efficacy in the treatment of clonal T‐cell diseases, including Sézary syndrome and allograft rejection. In this case report, we expand on this observation to include recalcitrant hepatic allograft rejection. A 14‐year‐old boy with hepatic allograft rejection refractory to high‐dose corticosteroid and lymphocytolytic therapy was treated with 4 sessions of ECP over a 6‐week period. After 2 sessions, a liver biopsy showed complete reversal of acute cell‐mediated rejection. No opportunistic infections or other adverse events were noted. Photopheresis appears to be a safe and effective modality for the treatment of refractory hepatic allograft rejection.

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