Antibody-mediated rejection of the cardiac allograft: where do we stand in 2012?

The review will discuss the current pathological criteria for the diagnosis and classification of antibody-mediated rejection (AMR) in the cardiac allograft.

Until recently, the diagnosis of AMR required clinical dysfunction, presence of donor specific antibodies and pathological alterations. The concept of asymptomatic AMR and its adverse long-term outcomes created, in part the need to reevaluate diagnostic criteria. The results of a recent consensus meeting sponsored by International Society For Heart And Lung Transplantation are discussed.

The diagnosis of AMR rests on histopathological and immunophenotypic findings. These provide the basis for a new grading scheme.