Table 2.
IS--modulating outcomes from included studies.
| Author and year | IS regimen at baseline | Change in standard IS regimena |
|---|---|---|
| Heart transplantation | ||
| Barr et al. (1998) (35) | Standard therapy alone (mean ± SD, n=27) • Cyclosporine, months 0–3: 4.6 ± 1.6 mg/kg/day • Cyclosporine, months 4–6: 4.7 ± 1.9 mg/kg/day • Azathioprine: dose NR • Prednisone: dose NR |
Standard therapy plus ECP (mean ± SD, n=33) • Cyclosporine, months 0–3: 4.3 ± 1.1 mg/kg/day • Cyclosporine, months 4–6: 4.4 ± 1.2 mg/kg/day • Azathioprine: dose NR • Prednisone: dose NR |
| Dall’Amico et al. (1995) (36) | Maintenance therapy in 6 months preceding ECP therapy (mean ± SD, n=8) • Prednisone: 15.1 ± 4.7 mg/day • Cyclosporine: 361 ± 129 mg/day • Azathioprine: 134 ± 43 mg/day |
Maintenance therapy during ECP (mean ± SD, n=8) • Prednisone: 9.4 ± 2.9 mg/day • Cyclosporine: 302 ± 129 mg/day • Azathioprine: 119 ± 55 mg/day |
| Goekler et al. (2022) (37) | Tacrolimus: dose NR Steroids: dose NR MMF: dose NR |
No change reported |
| Maccherini et al. (2001) (13) | Standard triple immunosuppressive therapy (cyclosporine, azathioprine, steroids; n=6) Monotherapy with cyclosporine (n=2) Cyclosporine and steroids at 0.1 mg/kg (n=3) |
Reduction of immunosuppression possible in all patients, especially steroids; specific doses NR |
| Savignano et al. (2017) (38) | Specific doses NR; standard triple immunosuppressive therapy consisted of the following: combination of prednisone/tacrolimus/MMF, prednisone/cyclosporin/everolimus or prednisone/cyclosporin/azathioprine | Reduction of standard immunosuppressive therapy (n/N=6/8) |
| Barten et al. (2023) (39) | Specific doses NR n (%) at the start of ECP treatment in patients with ongoing ECP treatment • Immunosuppressants: 47 (100%) • Rituximab: 2 (4.3%) • Steroids: 41 (87.2%) • Plasma exchange: 0 (0%) n (%) at the start of ECP treatment in patients with completed ECP treatment • Immunosuppressants: 58 (100%) • Rituximab: 1 (1.7%) • Steroids: 55 (94.8%) • Plasma exchange: 3 (5.2%) |
Specific doses NR n (%) at the last reported visit in patients with ongoing ECP treatment • Immunosuppressants: 47 (100%) • Rituximab: 0 (0%) • Steroids: 37 (78.7%) • Plasma exchange: 0 (0%) n (%) at the last reported visit in patients with completed ECP treatment • Immunosuppressants: 58 (100%) • Rituximab: 0 (0%) • Steroids: 47 (81.0%) • Plasma exchange: 0 (0%) |
| Lung transplantation | ||
| Schoch et al. (1999) (40) | Initial standard therapy • Cyclosporine: 250 μg/L • Azathioprine: dose NR • Prednisone: dose NR • Antithymocyte globulin: dose NR • Oral valaciclovir: 1.5 g/day A2 rejection treatment • Methylprednisolone: 1 g dose followed by 0.5 g/day for 2 days then tapered |
• Cyclosporine: 100 μg/L • Oral valaciclovir: 4.5 g/day |
| Steinack et al. (2020) (43) | Induction therapy • Basiliximab Initial standard therapy • Cyclosporine: C2 target level 1200–1500 μg/L after 48 hours • MMF: 1.0 g bid • Methylprednisolone: 30 mg, as per center standard • Anti-infective treatment: dose NR |
• Cyclosporine: C2 target level 180–200 μg/L • Methylprednisolone: 25 mg |
| Kidney transplantation | ||
| Jardine et al. (2009) (12) | Pre-ECP rejection therapy (mean, n=10) • Steroid pulse: 4.775 g in total • Antilymphocyte: 15.4 days therapy • Standard maintenance immunosuppressive therapy |
During ECP therapy • Steroid pulse: 1.05 g in total • Antilymphocyte: 1.7 days therapy Post-ECP therapy • Steroid pulse: 0.375 g in total • Antilymphocyte: 0 days therapy |
| Dall’Amico et al. (1998) (45) | Pre-ECP immune suppressive therapy (mean ± SD, n/N=3/4) • Prednisolone: 16 ± 11 mg • Cyclosporine A: 220 ± 58 mg/d • Azathioprine: 93 ± 12 mg/d |
6 months post-ECP immune suppressive therapy (mean ± SD, n/N=3/4) • Prednisolone: 8.5 ± 1 mg • Cyclosporine A: 217 ± 40 mg/d • Azathioprine: 93 ± 12 mg/d |
| Liver transplantation | ||
| Urbani et al. (2007) (49) | Initial standard therapy • Cyclosporine: 10 mg/kg/day • Tacrolimus: 0.1 mg/kg/day Antimetabolites and/or corticosteroids, as per center standard (dose NR) |
• Spared CNI IS: 1/18 ECP-treated patients • Delayed CNI IS ≤8 days: 11/18 (61.2%) • Delayed CNI IS >8 days: 6/18 (33.3%) |
CNI, calcineurin inhibitors; ECP, extracorporeal photopheresis; IS, immunosuppression; MMF, mycophenolate mofetil; NR, not reported.
aOnly treatments where a change in dosage is reported here with any treatment not listed remained unchanged.