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Néphrologie & Thérapeutique

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Immune modulation with extracorporeal photopheresis in renal transplantation: proof of concept clinical outcomes and perspective Volume 19, issue 6, October 2023

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Authors
1 Service de néphrologie, CHU Besançon, Bd A. Flemming, 25000 Besançon, France
2 UMR RIGHT 1098 Inserm/EFS/UFC, 25000 Besançon, France
3 Service de néphrologie, CHU Lille, Bd du Professeur Jules Leclercq, 59000 Lille, France
4 Service de néphrologie, CHU Angers, 4, rue Larrey, 49100 Angers, France
5 Service de néphrologie, CHU Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont-Ferrand, France
Correspondance : T. Crépin
tcrepin@chu-besancon.fr

For 30 years, photopheresis is used to treat graft versus host disease and heart or lung allograft rejection. In this review, we discuss the place of photopheresis in kidney transplantation both in prevention or treatment of rejection. Mechanisms of action in kidney transplantation are mainly based on results observed in graft versus host disease and in heart or lung transplantation. Photopheresis may induce innate and adaptive immunity changes with restauration of a favourable Th1/Th2 immune balance, an expansion of LT /LB reg subsets, and a local enrichment in IL-10. French national clinical and mechanistic studies are underway to define the place of photopheresis therapy in immunomodulation strategies in kidney transplantation.