Antibody-medicated rejection after heart transplantation: diagnosis and clinical implications

Purpose of reviewThe present article will review the diagnosis of antibody-mediated rejection in heart transplant recipients and further explore the clinical implications.Recent findingsImproved diagnostic techniques have led to increased recognition of antibody-mediated rejection and better understanding of the long-term consequences in heart transplant recipients. Endomyocardial biopsy remains the gold standard for the diagnosis of antibody-medicated ejection; however, several advances in molecular testing have emerged, including the use of gene expression profiling, messenger RNA, and microRNA. Routine surveillance of donor-specific antibodies identifies recipients at high risk for graft compromise. Additionally, new monoclonal antibody therapies have broadened our repertoire in the treatment of rejection.SummaryAdvances in molecular testing for antibody-mediated rejection may improve the associated long-term complication, while minimizing risk to the patient.