Table 3.
Overview of the eight articles reviewed in total lymphoid irradiation (TLI).
| Study | Patient study size | Gender | Age range (average age) | Treatment rationale | TLI dose | Patients who received entire prescribed dose | Average time before first rejection episode | Rejection episodes before TLI (average) | Rejection episodes after TLI (average) | Reported deaths |
|---|---|---|---|---|---|---|---|---|---|---|
| Diamond et al.14 | 11 | 10 Male 1 Female | 15–51 (33) | BOS refractory to conventional treatment | 0.8 Gy fx 8 Gy total | 4 | 18.6 months | Not stated | Not stated | 6 |
| Verleden et al.16 | ||||||||||
| TLI group | 6 | 3 Male 3 Female | 23–41 (32) | BOS no longer responding to azithromycin | 0.8 Gy fx 8 Gy total | Not stated | 11 months | Not stated | Not stated | 3 |
| Control group | 5 | Not stated | 23–54 (38) | No dose | No dose | Not stated | Not stated | Not stated | 1 | |
| Ghadja et al.175 | 7 | 4 Male 3 Female | 19–62 (46) | RCCAR endomyocardial biopsies | 0.8 Gy fx 8 Gy total | 2 | 33 months | 5.9 per patient | 1.7 per patient | 1 |
| Salter et al.20 | ||||||||||
| TLI group | 47 | 37 Male 10 Female | 9–64 (48) | early or recurrent cardiac rejection after immune suppressive drugs therapy | Range 2.4–8.4 Gy | 47 | 1–72 months majority 1–3 months | 1.43 episodes/patient/month | 0.10 episodes/patient/month | 7 |
| Control group received a heart transplant same centre and time frame but no TLI treatment | 88 | Not stated | Not stated | No dose | No dose | Not stated | Not stated | Not stated | NA | |
| Keogh et al.19 | ||||||||||
| TLI group | 7 | Male | 51–63 (Not stated) | Repetitive cardiac rejection episodes biopsy proven | 0.8 Gy fx 8 Gy total | 7 | Within 4 weeks of transplant | 3.4 ± 0.8 rejection episodes | 0.1 ± 0.4 rejection episodes | 0 |
| Tacrolimus group | 6 | Male | 53–62 (Not stated) | Grade 3A | No dose | 6 | 3.2 ± 0.4 rejection episodes | 0.7 ± 0.8 rejection episodes | 0 | |
| Tallaj et al.13 | ||||||||||
| TLI group | 66 | Not stated | Not stated | RCCAR endomyocardial biopsies | 0.8 Gy fx 8 Gy total | 55 | Not stated | 16 episodes per year | 6 episodes per year | 3 |
| Control group | 122 | Not stated | Not stated | NO dose | No dose | Not stated | Not stated | Not stated | Not stated | |
| Wolden et al.18 | ||||||||||
| TLI group | 47 | 34 Males 13 Females | 1–64 (48) | Persistent, intractable cardiac rejection | 0.8 Gy fx 8 Gy total | 36 | Not stated | 0.46 episodes/patient/month | 0.14 episodes/patient/month | 20 |
| Prophylactic group TLI given before a rejection episode | 10 | Not stated | Not stated | 0.8 Gy fx 8 Gy total | Cancelled due to high rejection rate during the treatment | NA | NA | NA | 4 | |
| Fisher et al.21 | ||||||||||
| TLI group | 37 | 16 Male 21 Female | Not stated (38) | Progressive BOS | 0.8 Gy fx 8 Gy total | 27 (completed 80% fx) | NA | NA | NA | 28 |
BOS, bronchiolitis obliterans syndrome; RCCAR, recalcitrant cellular cardiac allograft rejection; fx, fraction; TLI, total lymphoid irradiation.