Controversies in defining cardiac antibody-mediated rejection: Need for updated criteria

published online 02 March 2010.

Recent years have seen a rising awareness of the significance of cardiac antibody-mediated rejection (AMR) as a result of its formal recognition by the International Society for Heart and Lung Transplantation. New insights on the pathology and clinical behavior of cardiac AMR are at odds with current diagnostic guidelines. This perspective examines some of the contentious and unresolved issues in cardiac AMR as the transplant community makes concrete steps towards updating its defining criteria.

Keywords: antibody-mediated rejection, heart transplantation, controversies, ISHLT, diagnostic criteria

a Intermountain Medical Center and Intermountain Healthcare, Cardiac Transplant Program, Salt Lake City, Utah

b Utah Transplantation Affiliated Hospitals (U.T.A.H.) Cardiac Transplant Program, Salt Lake City, Utah

Reprint requests: Abdallah G. Kfoury, MD, Heart Failure Prevention and Treatment Program, Intermountain Medical Center, 5121 South Cottonwood Street, Salt Lake City, UT 84107. Telephone: 801-507-4637. Fax: 801-507-4811

PII: S1053-2498(09)00849-3

doi:10.1016/j.healun.2009.10.016

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