TRAnscriptional Profile of Peripheral Blood Cells in Patient With Chronic Kidney and Lung Rejection: Correlation With Response to Extracorporeal Photo-aphereSiS

Inclusion Criteria: * Age ≥ 18 years * Kidney transplant recipients with biopsy-proven AMCR * Lung transplant recipients with CLAD, defined as a persistent decline in FEV1 ≥ 20% compared with post-transplant baseline in the absence of other causes * Patients receiving standard immunosuppressive therapy and eligible for Extracorporeal Photoapheresis (ECP) * Ability to provide informed consent Exclusion Criteria: * Active infection or uncontrolled comorbidities that contraindicate ECP * Pregnancy or breastfeeding * Participation in another interventional trial that could interfere with outcomes * Inability to comply with study procedures Additional Notes: * Both prevalent and incident cases may be included (ambispective design). * Patients will be followed longitudinally for clinical outcomes, donor-specific antibodies, and gene expression profiling at baseline, 6 months, and 12 months.