Innovative Applications of Extracorporeal Photopheresis in Solid Organ Transplantation

Objective
Organ transplantation remains the only definitive treatment for end-stage heart, lung, liver or kidney disease. Early transplant outcomes are now generally excellent, dramatically reducing patients’ mortality and morbidity. Nevertheless, transplantation still faces significant obstacles, especially long-term immunosuppression-related toxicity and chronic decline of transplant function, which are the leading causes of transplant failure. To break these barriers, which represent a very significant societal and economic burden in the EU, there is a need for innovative therapies to lessen our reliance on conventional immunosuppression and better control non-resolving inflammation. Extracorporeal photopheresis (ECP) is now being investigated as a personalized, adjunct immunosuppressive therapy in some organ transplant settings. However, ECP is regarded as a controversial therapy, primarily because current understanding of its pharmacological actions is incomplete, but also because there remain questions about optimal manufacturing processes, quality-control and personalized clinical indications. The exTra project asks whether a better mechanistic understanding of ECP can guide us more efficiently towards novel applications. Specifically, exTra brings together European experts in clinical transplantation, immunology, pharmaceutical development, computational biology and medical device manufacture to address key questions through a coordinated, interdisciplinary effort. exTra proposes 10 independent doctoral research projects with the ambition of providing its trainees with a comprehensive understanding of basic and translational immunology, especially relating development and licensing of new immunotherapies. Through its research and training activities, the exTra project will contribute to scientific advancement and innovation in Europe, ultimately leading to societal and economic benefits stemming from clinical innovations in transplant immunotherapy and beyond.