A newly published review in Transplantation Direct explores the growing significance of
extracorporeal photopheresis (ECP), a therapy that modulates immune responses using
patients’ own treated blood cells. The article, authored by Panagiotis Parsonidis, MSc, and Prof. Thomas Wekerle of the Medical University of Vienna, Austria, highlights extracorporeal photopheresis’s established safety record while pointing to future opportunities for innovation in cell-based medicine.
Extracorporeal Photopheresis works by collecting white blood cells, treating them with a
photosensitizing drug (8-methoxypsoralen) and Ultra Violet (UVA) light, and then reinfusing
them into the patient. This process induces controlled apoptosis of immune cells, which in turn helps regulate immune activity. The therapy is currently approved by the United States Food and Drug Administration for cutaneous T-cell lymphoma and by the European Medicines Agency for graft-versus-host disease (GVHD).
Beyond these uses, extracorporeal photopheresis is frequently applied off-label in solid organ transplantation—particularly in heart, lung, kidney, and liver grafts. Evidence suggests that it may help reduce transplant rejection while minimizing the need for conventional
immunosuppressive drugs and their associated side effects.
Researchers are also investigating its potential for autoimmune conditions like lupus, Crohn’s
disease, and type 1 diabetes. However, the review emphasizes that the field is at a crossroads. As scientists explore advanced modifications such as loading dendritic cells with antigens or genetically engineering immune cells, extracorporeal photopheresis products may soon be reclassified as Advanced Therapy Medicinal Products (ATMPs) under European regulation. This shift would impose stricter manufacturing and quality-control standards but could also challenge patient access, particularly in smaller treatment centres.
Economically, extracorporeal photopheresis has shown promising results. Studies indicate
significant cost savings for healthcare systems by reducing long-term dependence on
immunosuppressants and lowering hospital resource utilization.
The authors conclude that while extracorporeal photopheresis is already a “long-established, safe, and effective therapy,” its next evolution may be as a cutting-edge, regulated form of cell therapy. The balance between innovation and accessibility will be crucial as regulators, clinicians, and patients navigate its future.
Summary by Alena Adarbehova, volunteer for the Alliance for Pulmonary Hypertension
Read more at this link on Transplantation Direct
Citation
Parsonidis P, Wekerle T. Extracorporeal Photopheresis: Does It Have a Potential Place Among
Cell-based Therapies? Transplantation Direct. 2025;11:e1808.
doi:10.1097/TXD.0000000000001808
