Review Article

Antibody-Mediated Rejection: An Evolving Entity in Heart Transplantation

Table 1

Definition of allograft dysfunction (≥1 criteria required).

Clinical heart failureSymptoms and signs of low cardiac output and/or pulmonary or systemic congestion

HemodynamicsPCWP > 20 mm Hg, and CI < 2.0 L/min/m2

InotropesRequirement for inotropic drugs

Restrictive physiologyEchocardiogram: LVEF >50%, E to A ratio >2, IVRT <60 ms and DT <150 ms
Or
Right heart catheterization: RAP >12 mm Hg, PCWP >25 mm Hg and CI < 2.0 L/min/m2

Systolic dysfunctionLVEF ≤45% or FS ≤20% or ≥25% decrease of LVEF or FS from baseline

A: A-wave, CI: cardiac index, DT: deceleration time, E: E-wave, FS: fractional shortening, IVRT: isovolumic relaxation time, LVEF: left ventricular ejection fraction, PCWP: pulmonary capillary wedge pressure, and RAP: right atrial pressure.