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Cardiologia Croatica, Vol. 19 No. 11-12, 2024.

Meeting abstract

https://doi.org/10.15836/ccar2024.419

The effect of prophylactic extracorporeal photopheresis on cardiac allograft vasculopathy during the first post-transplant year in de novo heart transplant recipients: ECP-OCT2019 study design

Mia Dubravčić Došen orcid id orcid.org/0000-0003-0441-4772 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Hrvoje Jurin ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Marijan Pašalić orcid id orcid.org/0000-0002-3197-2190 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Branka Golubić Ćepulić orcid id orcid.org/0000-0002-3067-0414 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Ines Bojanić orcid id orcid.org/0000-0002-2985-7847 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Sanja Mazić orcid id orcid.org/0000-0003-4166-6768 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Dora Fabijanović orcid id orcid.org/0000-0003-2633-3439 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Nina Jakuš orcid id orcid.org/0000-0001-7304-1127 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Ivo Planinc orcid id orcid.org/0000-0003-0561-6704 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Jure Samardžić orcid id orcid.org/0000-0002-9346-6402 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Maja Čikeš orcid id orcid.org/0000-0002-4772-5549 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Daniel Lovrić orcid id orcid.org/0000-0002-5052-6559 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Kristina Marić Bešić orcid id orcid.org/0000-0002-4004-7271 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Joško Bulum orcid id orcid.org/0000-0002-1482-6503 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Hrvoje Gašparović orcid id orcid.org/0000-0002-2492-3702 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Davor Miličić orcid id orcid.org/0000-0001-9101-1570 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Boško Skorić orcid id orcid.org/0000-0001-5979-2346 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia

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Abstract

Keywords

cardiac allograft vasculopathy; intimal thickening; extracorporeal photopheresis; optical coherence tomography

Hrčak ID:

327909

URI

https://hrcak.srce.hr/327909

Publication date:

13.12.2024.

Visits: 366 *

Copyright statement: Croatian Cardiac Society

Copyright: 2024, Croatian Cardiac Society

Date received: 12 October 2024

Date: 31 October 2024

Publication date: November 2024

Publication date: November 2024

Volume: 19

Issue: 11-12

Page: 419

Publisher ID: CC 2024 19_11-12_419

DOI: 10.15836/ccar2024.419

Article Information (continued)

Categories:

Subject: Extended Abstract

Categories:

Subject: Heart failure

KEYWORDS: :

KEYWORDS:

Keyword: cardiac allograft vasculopathy

Keyword: intimal thickening

Keyword: extracorporeal photopheresis

Keyword: optical coherence tomography

The effect of prophylactic extracorporeal photopheresis on cardiac allograft vasculopathy during the first post-transplant year in de novo heart transplant recipients: ECP-OCT2019 study design

[https://orcid.org/0000-0003-0441-4772] Mia Dubravčić Došen[*]

[https://orcid.org/0000-0002-2599-553X] Hrvoje Jurin

[https://orcid.org/0000-0002-3197-2190] Marijan Pašalić

[https://orcid.org/0000-0002-3067-0414] Branka Golubić Ćepulić

[https://orcid.org/0000-0002-2985-7847] Ines Bojanić

[https://orcid.org/0000-0003-4166-6768] Sanja Mazić

[https://orcid.org/0000-0003-2633-3439] Dora Fabijanović

[https://orcid.org/0000-0001-7304-1127] Nina Jakuš

[https://orcid.org/0000-0003-0561-6704] Ivo Planinc

[https://orcid.org/0000-0002-9346-6402] Jure Samardžić

[https://orcid.org/0000-0002-4772-5549] Maja Čikeš

[https://orcid.org/0000-0002-5052-6559] Daniel Lovrić

[https://orcid.org/0000-0002-4004-7271] Kristina Marić Bešić

[https://orcid.org/0000-0002-1482-6503] Joško Bulum

[https://orcid.org/0000-0002-2492-3702] Hrvoje Gašparović

[https://orcid.org/0000-0001-9101-1570] Davor Miličić

[https://orcid.org/0000-0001-5979-2346] Boško Skorić

 

University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia

Author notes:

Correspondence to: [*] ADDRESS FOR CORRESPONDENCE: Mia Dubravčić Došen, Klinički bolnički centar Zagreb, Kišpatićeva 12, HR-10000 Zagreb, Croatia. / Phone: +385-98-954-9898 / E-mail: dubravcic.mia@gmail.com

Introduction: Cardiac allograft vasculopathy (CAV) remains a major cause of long-term morbidity and mortality after heart transplantation (HTx). Coronary intimal thickening that occurs during the first post-HTx year is an early sign of CAV. (1) To the best of our knowledge, only one study has reported of decreased intimal thickening in HTx recipients who received prophylactic extracorporeal photopheresis (ECP) in addition to maintenance immunosuppressive therapy (IST) consisting of cyclosporine, azathioprine, and steroid. (2) The ECP-OCT2019 trial is designed to evaluate the effect of prophylactic ECP on intimal thickening during the first post-HTx year, as assessed by optical coherence tomography (OCT), in light of modern IST which includes mycophenolate mofetil, proven to have advantages over azathioprine in CAV prevention.

Study design: ECP-OCT2019 is a pilot, interventional, prospective, randomized, open-label study. A total of 38 patients were randomized into two arms to receive either 10 cycles of ECP treatment in addition to standard IST or standard IST alone. In all patients, coronary angiography with OCT imaging was performed within the first three months after HTx and repeated one year after HTx to detect progression of intimal thickening. The primary endpoint was defined as the change in intimal volume from baseline to one-year follow-up. Secondary endpoints included changes in maximal and mean intimal thickness, maximal and mean intimal layer area, as well as minimal and mean lumen area.

Conclusion: ECP-OCT2019 is the first prospective study to evaluate the effect of prophylactic ECP on intimal thickening in HTx recipients in the context of modern IST. Our results may influence current clinical practice in CAV prevention and diagnostics.

LITERATURE

1 

Khush KK, Cherikh WS, Chambers DC, Harhay MO, Hayes D Jr, Hsich E, et al. International Society for Heart and Lung Transplantation. The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-sixth adult heart transplantation report - 2019; focus theme: Donor and recipient size match. J Heart Lung Transplant. 2019 October;38(10):1056–66. https://doi.org/10.1016/j.healun.2019.08.004 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/31548031

2 

Barr ML, Baker CJ, Schenkel FA, McLaughlin SN, Stouch BC, Starnes VA, et al. Prophylactic photopheresis and chronic rejection: effects on graft intimal hyperplasia in cardiac transplantation. Clin Transplant. 2000;14(2):162–6. https://doi.org/10.1034/j.1399-0012.2000.140211.x PubMed: http://www.ncbi.nlm.nih.gov/pubmed/10770423

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