According to the ISHLT, more than 4,000 patients undergo a heart transplant each year, and almost 4,000 receive single or double lung transplants. Their prognosis depends heavily on the avoidance of rejection, which claims the majority of their lives. For heart transplant recipients, the median survival is 11 years, while for lung transplant recipients, it is approximately 5 years. The current most common anti-rejection methods include drugs such as corticosteroids and others such as calcineurin inhibitors. While there is some evidence that ECP is beneficial to prevent and treat rejection in patients with heart transplants, the evidence is very limited for lung transplants. There is much to be elucidated regarding the role of apheresis.